031315 antimanic drugs

Question 1

lithium

Answer 1

no behavioral effects in the normal population

treats mania and prevents recurrence of bipolar disease

inhibits phosphtase that converts IP2 to IP1

Question 2

pharmacokinetics of lithium

Answer 2

narrow therapeutic window

Na levels affect Li levels (increased Na excretion causes clinically significant increases in Li levels)

Question 3

alternatives to lithium for tx of bipolar disorder

Answer 3

carbamazepine

valproic acid and divalproex sodium

lamotrigene, topiramate

for intial control of manic symptoms: haloperidol or clonazepam

symbyax (combo of olanzapine and fluoxetine)