What are first line treatments for bipolar?
Mood stabilizer
SGAs
What is not considered a mood stabilizer?
Antidepressants
SGAs have some antidepressant effect without inducing what?
Depression
Lamotrigine is used in what two ways in bipolar?
Bipolar depression
Maintenance
Lamotrigine has no effect on what part of bipolar?
Mania
Lithium is used in what aspects of bipolar?
Mania
Depression
Maintenance
What 2 anticonvulsants are approved in bipolar mania?
Valproate
Carbamazepine
carbamazepine name brand for bipolar?
Equetro
Which mood stabilizer is pregnancy C?
Lamotrigine
Lamotrigine can cause what side effect if titrated too fast?
Rash
What bad SE can lamotrigine cause?
Aplastic anemia
Agranulocytosis
What is valproate therapeutic range?
50-125
Supplement valproate therapy with what?
Vitamin d and calcium
Valproate can cause what 4 scary serious side effects?
Hepatic failure
Teratogenicity
Pancreatitis
Mitochondrial disease
Valproate can cause what two non serious side effects?
Weight gain
Tremor
Supplement carbamazepine therapy with what?
Vit d and calcium
Genetic testing with carbamazepine?
HLAB 1502 in Asians
Carbamazepine can cause what 2 serious side effects?
SJS / TEN
agranulocytosis
What is carbamazepine therapeutic range?
4-12
What is lithium’s therapeutic range?
0.6-1.2
Cannot use lithium in what patient population?
Renal impairment
Lithium is 100% really eliminated
A decrease in salt intake will do what to lithium levels?
Increase lithium levels
At what levels will lithium toxicity occur?
> 1.5
> 3.0
Increase risk of serotonin syndrome with what mood stabilizer since its serotonergic?
Lithium
Maintain adequate fluid intake with which mood stabilizer?
Lithium
8-12 glasses per day
Do not change consumption of what with lithium therapy?
Salt
4 mood stabilizers in bipolar?
Lithium
Valproate
Lamotrigine
Carbamazepine