Bipolar Disorder Flashcards
(26 cards)
What is bipolar 1
At least 1 episode of mania followed by bouts of depression
What is bipolar 2
At lest 1 episode of hypomania and 1 depressive episode
What are the characteristics of mania
Psychosis, delusions that may require hospitalizarion
What is hypomania
Does not affect social/work functioning, doesn’t case psychosis nor hospitalization
Sx of mania
Inflated self-esteem
Less sleep
Talkative
Jumping from topic to topic
Distracted
Goal-directed
High risk, pleasurable activite
What is the diagnosis of mania
≥3 sx (if mood is only irritable, exhibits ≥4 sx)
What is the goal for bipolar treatment?
Stabilize the mood without inducing mania or depression
What are the mood stabilizers
Lithium
Antieliptics: Valproate, lamotrigine, carbamazepine
What is the treatment of choice for acute manic episode?
Antipsychotics (olanzapine, risperidone), lithium ,valproate → Combination is preferred for severe
What is the treatment of choice for acute depressive episodes
Antipsychotics (quetiapine, lurasidone), lithium, valproate, lamotrigine
Drugs used for the chronic maintenance of bipolar?
Lithium, antiepoleptics, SGAs
Class of drugs where MedGuides are required
Antidepressants and antipsychotics → increased risk of death in patients with dementia-related psychosis
Antiepileptics for Bipolar
Lamital
Valproate
Carbamazepine
Dosing of Lamictal
Requires slow iteration to avoid risk of severe rash → not for acute mania
Valproate
Depakote
SGA indicated for bipolar
Aripriparzole
Olanzapine
Quetiapine
Risperidone
Ziprasidone
Lurasidone
Lithium
Lithobid
Therapuetic range of lithium
0.6-1.2
ADR of lithium
Serotonin syndrome, GI upset (take with food)
Cognitive effects
Cogwheel rigidity
Tremor
Polyuria, polydipsia
Weight gain
Hypothyroidism
Teratogenic
Signs of lithium toxicity
> 1.5: ataxia, coarse hand tremor, vomiting
> 2.5: CNS depression, arrhythmias, sx, coma
Drugs that increase lithium levels?
ACEI, ARBS, NSAIDs, ↓ salt intake
Drugs that ↓ lithium levels
↑ salt intake, caffeine, theophylline
MOA of lithium
Influence the reuptake of serotonin and NE or by moderating glutamate levels
Lithium conversions
5 mL lithium citrate = 8 mEq of Li ion
8 mEq Li ion = 300 mg Lithium carbonate tabs/caps
