Flashcards in xx. Mood Stabilizers Deck (21)
what are mood stabilizers used for?
to prevent the extreme mood swings between mania and depression, typical of bipolar disorder.
what is the classic mood stabilizer?
what are anti-convulsants that are used for mood stabilizing?
valproate, carbamazepine, lamotrigine, oxcarbazepine
what is an anti-psychotic used as a mood stabilizer?
one problem with lithium?
narrow therapeutic range, must be monitored
what is lithium sensitive to?
volume of distribution is same as body water; anything that changes body water can cause toxic incr in lithium levels.
side effects of lithium?
ataxia, lethargy, wt gain
olanzapine used at what point of bipolar treatment?
at the start, if treating with lithium or valproic acid. the half lives of those are long, can take days to get effect.
olanzapine also approved as what?
monotherapy for mania
valproate: class? mech? warnings?
anti-convulsant, mood stabilizer. increases GABA effects. hepatotoxic, teratogen, pancreatitis
carbamazepine: class? mech? warnings?
anti-convulsant, mood stabilizer. Blocks Na channels. effects activity of other drugs, can have derm reactions
lamotrigine: class? mech? warnings?
anticonvulsant, mood stabilizer. blocks Na channels. Serious skin rashes.
oxcarbazepine: class? mech? warnings?
anticonvulsant, mood stabilizer. blocks Na channels. more expensive than carbamazepine.
olanzapine: class? mech? warnings?
atypical antipsychotic, mood stabilizer.
Blocks 5HT2A and D2 receptors.
QT prolongation, not for dementia-related psychosis, not for elderly dementia pts
preferred bipolar med for pregnancy?
management of acutely manic patient?
start on olanzapine: rapid onset. mood stabilizer to manage the condition long-term (lithium, valproate, lamotrigine)
longer-term management of a bipolar patient?
taper off atypical antipsychotic once acute mania has worn off and mood stabilizer has reached steady state.
what can anti-depressants do in bipolar patients?
monotherapy with antidepressants can induce mania
what do many people with bipolar take?
a mood stabilizer combined with an antidepressant.
what are 2 things that can cause toxic levels of lithium?
running a marathon, diuretic (decr body water)