Mood Stabilizing Drugs

Question 1

Lithium

Answer 1

In the last 100 years, Li salts have been used to treat gout, diabetes, epilepsy and mania.

USE: treatment of choice for Bipolar Disorder, including classic bipolar dx involving manic episodes with elevated mood (not irritable or dysphoric) and w/o a rapid cycling of moods.

1. reduces or liminiates manic symptoms and also suppresses mood swings!

Mode of Action: related to reuptake of serotonin and norepinephrine.

Side Effects: gastrointestinal side effects usually subside w/in a few weeks and include nausea, vomiting, diarrhea, metallic taste, weight gain, hand tremor, shakiness, fatigue, restlessness, polyuria, polydipsia.

1. Toxicity: dose is too high, diarrhea, ataxia, drowsiness, slurred speech, confusion and coarse tremor.
2. seizures, coma, and death so blood levels are important.
3. Retention of Li is affected by the body’s sodium levels= must be careful to avoid fluctuations in salt intake, avoid caffeine, alcohol, and other diuretics.
4. Not for people with cardiovascular, kidney, liver, thyroid or GI problems.

Question 2

Carbamazepine

Answer 2

Carbamazepine (tegretol): initially a anticonvulsant drug but has been found effective for mania.

other anticonvulsant drugs useful for mood dx:

1. Valproic acid (depakote)
2. Clonazepam (Klonopin)

USE: effective for Bipolar Dx, esp for those not responding to Li.

1. Some evidence that it is better for for those with frequent mood swings (rapid cyclers) and those with dysphoric mania.

Mode of Action: believed to affect serotonin levels.

Side Effects: dizziness, ataxia, visual distrubances, anorexia, nausea, and rash. Tolerance develops fairly quickly.

1. Risk for Cardiovascular functioning: contraindicated for heart conditions.
2. slight risk of agranulocytosis and aplastic anemia, so blood monitoring is required.