Anti-psychotics and Mood Stabilizers Flashcards
Antipsychotics
Used to treat bipolar and schizophrenia
May be more effective monotherapy than mood stabilizers
1st generation cause EPS - Treat with Cogentin
EPS SE: tardive dyskinesia, neuroleptic malignant syndrome
1st Generation Antipsychotics
Haloperidol (Haldol), Chlorpromazine (Thorazine)
Effective in treating positive sx schizophrenia but not significant recovery and serious SE
SE: Akathisia, EPS, Parkinsonian-like rigidity/tremor
Check CPK for muscle breakdown
Dyskinesia
Akathisia
Dystonia
And treatment
Dyskinesia = repetitive, involuntary, purposeless movements
Akathisia = internal/external restlessness
-can’t sit still, jitteriness, shaky with suicidal ideation
Dystonia = very strong muscular contractions causing abnormal posturing
Treat w/ Cogentin - blocks Ach to reestablish Ach and Dopamine balance
2nd Generation Antipsychotics
Less SE, effective in treatment of negative sx
SE: Monitor for glucose intolerance, causes weight gain
-apine, -idone, -prazole
2nd generation antipsychotic
Weight gain is major SE
Levels decreased w/ smoking
Olanzapine (Zyprexa)
2nd generation antipsychotic
Major SE is drowsiness, hyperprolactinemia
Tx mood and anxiety disorders, PTSD, Parkinsons
Quetiapine (Seroquel)
2nd generation antipsychotic
less weight gain - people typically like it
Ziprasidone (Geodon)
2nd generation antipsychotic
Major SE is agranulocytosis - monitor CBC
Also weight gain
Effective in treatment resistant patients
Clozapine (Clozaril)
2nd generation antipsychotics
Very expensive
Unique, unpredictable effect on other antipsychotic activity
Aripiprazole (Abilify)
Mood Stabilizer
1st line for bipolar with 2nd gen antipsychotic
Low therapeutic index - requires constant level monitoring 12 hours after last dose
Check for renal and thyroid toxicity
Pregnancy D
Can cause serotonin syndrome
Lithium
Mood Stabilizer - anticonvulsant
1st line for bipolar acute depression - doesn’t trigger mania
SE: Steven Johnsons Syndrome
Not for acute mania - only used after manic episode resolves
Lamotrigine (Lamictal)
Mood Stabilizer - anticonvulsant
1st line for bipolar disorder manic episode + 2nd gen antipsych
Less SE than lithium
BBW: Hepatotoxicity
Quick onset w/ large therapeutic window
Monitor pancreas, liver (BBW), and pancytopenia
Valproate (Depakote)
Mood stabilizer - anticonvulsant
Efficacy comparable to lithium
Narrow Therapeutic window
Check levels, CBC, thyroid, and LFTs
BBW: Steven-Johnsons Syndrome
Category X for pregnancy - teratogen
Carbamazepine (Tegretol)
2nd generation antipsychotics
Most commonly used
No anticholinergic effects
Risperidone (Risperdal)
Alprazolam
Xanax
long onset - 1 hour
11-15 hour half life - short
