Bipolar Disorder Drugs

Question 1

quetiapine

Answer 1

TRADE: Seroquel
CLASS: atypical antipsychotics
FDA approval: tx of schizophrenia, bipolar mania, and bipolar depression
MAIN points:
1) has versatile use
2) good efficacy and tolerability
3) evidence of abuse among adolescents and misuse among adults
4) abnormal motor movements not as common

Question 2

lurasidone

Answer 2

TRADE: Latuda
CLASS: atypical antispychotic
FDA approval: tx of schizophrenia and bipolar disorder (as a monotherapy & as an adjunctive to lithium or valproate)
MAIN points:
1) affects both dopamine and serotonin receptors
2) missing doses may increase risk of relapse in symptoms
3) limited information about overdosing
4) potential benefits for MDD, but can worsen suicidality

Question 3

ziprasidone

Answer 3

TRADE: Geodon
CLASS: atypical antipsychotic
FDA approval: tx of bipolar 1 disorder mixed episodes and manic episodes & tx of schizophrenia
MAIN points:
1) over 20 years of proven efficacy and shown positive outcomes so far
2) extremely effective in treating acute mania when administered intramuscularly
3) only be used if benefits outweigh risks
4) severe side effects are rare and drug is tolerated by most

Question 4

lamotrigine

Answer 4

TRADE: Lamictal
CLASS: anti epileptic / anticonvulsant
FDA approval: bipolar disorder
MAIN points:
1) assists with delaying the onset of bipolar depression episodes & increasing the time between mood episodes
2) usage and dosage must be carefully administered to monitor any signs of rash and assess for Stevens-Johnson disease
3) the mechanism of action is not fully clear, but the clinical profile results in antiseizure and psychotropic properties

Question 5

_____ (Depakote) is a GABA agonist/glutamate antagonist that is better for mixed episodes than lithium and is a teratogenic (causes fetal abnormalities).

Answer 5

valproate

Question 6

carbamezepine (Tegretol) causes leucopenia and _____.

Answer 6

agranulocytosis

Question 7

Because it is not metabolized by the liver and has an excellent safety profile, ______ is a more suitable drug for those who have compromised liver function.

Answer 7

gabapentin/pregabalin

Question 8

_______ can be used with other bipolar disorder drugs to counteract the weight gain seen in BP disorder drugs as it induces weight loss.

(cannot be used as a standalone tx)

Answer 8

topiramate (Topamax)