mood stabilizers

Question 1

Why or why cant you use antidepressants for bipolar

Answer 1

dont treat manic episodes, can precipitate mania

Question 2

most probable mech of action of mood stabilizers, esp lithium

Answer 2

decrease glutamate activity, increase GABA activity. Li doesnt act at synaptic site (acts intracellularly)

Question 3

How is Li metabolized? When would you want to test levels?

Answer 3

unmetabolized by kidney. 5 days after changing dosing, 12 hrs after dose. Should be ~1.0 mEq/L

Question 4

Li side effects

Answer 4

LMNOP. Movement (tremor), Nephrogenic diabetes insipidus, hypOthyroidism, Pregnancy problems (ebstein anomaly). Also, sinus bradycardia

Question 5

four causes of Li toxicity and three other dz that can cause it

Answer 5

ingesting excess Li, drug interactions, dehydration, decreased Na intake. renal dz, CHF, cirrhosis

Question 6

four commonly used anticonvulsants for mood stabilization

Answer 6

valproic acid, carbamazepine, oxcarbazepine, lamotrigine

Question 7

which anticonvulsant(s) cause neural tube defects

Answer 7

valproic acid, carbamazepine and probably oxcarb.

Question 8

which anticonvulsant increases metabolism by CYPs? decreases?

Answer 8

carbamazepine, valproic acid

Question 9

which anticonvulsant would you use for acute manic episodes? maintenance in case of Li intolerance

Answer 9

valproic acid, lamotrigine