Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHAR 358 > Bipolar > Flashcards

Bipolar Flashcards

1
Q

Define mood

A

a pervasive and sustained emotion of feeling tone that influences a persons behaviour and colors his or her perception of the world
- can be labile, fluctuating or alternating rapidly between extremes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is bipolar 1 disorder?

A

a distinct period of at least 1 week of full manic episode: abnormally and persistently elevated mood and increased energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is bipolar 2 disorder?

A

a current or past hypomanic episode and a current or past major depressive episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

men have more ______ episodes and women have more _____ or ______

A

manic; depressive; mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

is there a cure for bipolar?

A

no but full recovery/maintenance is possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the etiology of BD?

A

developmental, genetic, psychological, and neurobiologic factors may all contribute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk factors for BD

A

drug or alcohol abuse
medical conditions
period of high stress
having a 1st degree relative
major life changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which medical conditions are risk factors for BD?

A

hyperthyroidism
hormonal changes
CNS disorders
endocrine dysregulation
CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which medications can induce mania?

A

alcohol intoxication
antidepressants
DA-augmenting agents (CNS stimulants: amphetamines, cocaine, caffeine)
marijuana intoxication
steroids
thyroid preparations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when is the typical onset of bipolar?

A

typically before 25 yo
avg. 20-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what happens for those who develop illness before age 19?

A

longer delay to treatment
greater depressive symptom severity
higher levels of comorbid anxiety/substance use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why is it important to get people are the right therapy early and keep them on it?

A

to slow down potential neurodegeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what comorbid conditions may worsen existing BD or make treatment challenging?

A

anxiety disorders(50-60%)
substance use disorder(60%)
ADHD(20%)
PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the leading cause of death in BD?

A

suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what manual is used to diagnose bipolar?

A

DSM-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the diagnostic criteria for mania relating to symptoms?

A

persistently and abnormally elevated mood(irritable or expansive) and energy, with at least 3 of the following changes from usual behaviour:
1. grandiosity/high self-esteem
2. decreased need for sleep
3. racing thoughts
4. increased talking/pressured speech
5. distractability
6. increased goal-directed or psychomotor agitation
7. excessive engagement in high risk behaviours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how long must symptoms be occurring to be considered a mania diagnosis?

A

nearly every day for at least 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

after considering symptoms what other criteria must be met for a mania diagnosis?

A

leads to significant functional impairment OR includes psychotic features OR necessitates hospitalization AND episode is not due to physiological effects of a substance or another medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

if mania was caused by a medication but stops after d/c that medication, does the patient have bipolar?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the pneumonic for mania symptoms?

A

DIGFAST
(slide 22)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the DSM-5 criteria for BDI?

A

manic episode REQUIRED for diagnosis
hypomanic episode or major depressive episodes may occur before or after manic episode but are NOT required for diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diagnostic criteria for hypomanic episode

A

same symptom criteria as manic episode but only lasting up to 4 days
unequivocal change in functioning or mood that is uncharacteristic of the individual and/or observable by others
hospitalization not required. no psychosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the DSM-5 criteria for BDII?

A

hypomanic episode AND major depressive episode (current or past episodes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the diagnostic criteria for a major depressive episode?

A

5+ symptoms must be present nearly everyday during the same 2-week period and result in change in functioning and must include 1 or both of:
- depressed mood most of the day, nearly every day
- diminished interest or pleasure in all or most activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the symptoms for diagnosing a major depressive episode?

A

S - sleep pattern changes
I - interests or activity changes
G - guilty feeling or increased worry
E - energy changes
C - concentration changes
A - appetite changes
P - psychomotor disturbances
S - suicidal ideation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the mood disorders questionnaire(MDQ)?

A

3 question, 13 item PATIENT RATED used to screen for possible BD
- most specific for identifying BDI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is a positive MDQ score?

A

yes to 7/13 items from Q1
yes to Q2
“moderate or severe problem” for Q3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is bipolar often misdiagnosed as?

A

MDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are some of the challenges in BD diagnosis and treatment?

A

delay to diagnosis
misdiagnosis
limited clinical trials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the response time for mania treatment?

A

1-2 weeks
full clinical benefit 3-4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the response time for depression treatment?

A

2-4 weeks
full clinical benefit 6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the non-pharm therapy for BD?

A

exercise, adequate sleep, healthy diet, decreased/abstinent substance use, decreased caffeine/nicotine/alcohol
bright light (depression)
relapse prevention plan
CBT, therapy
ECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is included in a wellness recovery action plan (WRAP)?

A
  • early warning symptoms
  • tools when threat of crisis starts
  • what they have to do to stay well
  • their responsibilities
  • how they feel when they are well
  • what they do and who they entrust to do things when in crisis
  • list of people they can call in crisis
  • their triggers
  • post-crisis plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what mood stabilizers are used in BD?

A

lithium
anticonvulsants ex. valproic acid & lamotrigine
atypical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are the most commonly used mood stabilizers?

A

lithium
valproic acid/divalproex
lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are the indications of lithium?

A

BD - acute mania or prophylaxis/maintenance
schizoaffective disorder
unipolar depression - antidepressant augmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the bioavailability of lithium?

A

liquid: 100%
regular caps: 95-100%
ER tab: 60-90%
(very good F)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what side effects may be related to the onset and peak of lithium?

A

tremors or nausea
quick onset of 30-60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

how does lithium act in the body?

A

distributes evenly in the total body water space - the body treats lithium like a salt
- very well absorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

how is lithium metabolized?

A

it is eliminated mainly by the kidneys (95% renal elimination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what decreased the clearance of lithium?

A

hyponatremia, dehydration, renal failure or dysfunction, decreased renal blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

which medications are associated with the potential for lithium toxicity?

A

ACEi
NSAIDs
thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is lithiums therapeutic range for acute mania? maintenance therapy? elderly?

A

acute mania: 1.0-1.2mmol/L
maintenance: 0.6-1.0mmol/L
elderly: 0.6-0.8mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

at what lithium level would we start to see signs of toxicity?

A

> 1.5mmol/L - drowsy, ataxia, tremor, slurred speech, hypertonicity
2mmol/L - decreased HR, arrhythmia’s, seizures, myocarditis, coma, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when should a lithium sample be taken?

A

12 hours post dose - usually in am after the evening dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how frequently should lithium sampling be done?

A

5-7 days after starting therapy or changing dose, then once weekly until at a stabilized x 2 weeks, then monthly for up to 3 months, then at least every 6 months (once on long term therapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

how can we minimized GI side effects of lithium?

A

give with food or divide dose BID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

when is lithium CI?

A

in acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

do we need to adjust lithium doses in renal impairment?

A

yes once below 50mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what factors can decrease lithium levels?

A

caffeine
sodium supplement
burns
pregnancy
excessive fluid intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what factors can increase lithium levels?

A

NSAIDS
thiazide diuretics
ACEi/ARBs
dehydration
sodium loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what medications increase the risk of neurotoxicity when used with lithium?

A

antipsychotics or carbamazepine

53
Q

what are the drug interactions for lithium?

A

diuretics - potentially mixed effects
NSAIDs - increase Li concentration
ACEi - increase Li concentration

54
Q

what are the adverse effects of lithium?

A

dose related:
- increased thirst
- fine tremors
- headache, sedation, weakness
- GI upset
more long term:
- skin changes
- alopecia
- weight gain (avg 4-6kg in first 2 years)

55
Q

what are the serious (idiosyncratic) AE’s of lithium?

A

hypothyroidism
renal injury
nephrogenic diabetes insipidus medical emergency

56
Q

what do we do if a toxic lithium level is observed?

A

hold dose
repeat plasma level next day
restart therapy when within target range

57
Q

what are some monitoring parameters for lithium?

A

manic and depressive symptoms
CBC (with differential)
weight
electrolytes
thyroid function (TSH)
renal function (Scr, urea)
ECG
lithium concentrations
side effects
suicide risk

58
Q

what are some important counselling points for lithium?

A

maintain consistent fluid, caffeine, and salt intake
avoid NSAIDs and check with pharmacist before starting any new meds
consider contraception if child-bearing potential

59
Q

what are the benefits of once daily dosing HS for lithium?

A

less AEs and risk of renal injury

60
Q

What are the indications of valproic acid?

A

Seizures
Bipolar disorder

61
Q

What are the possible MOA’s of valproic acid for bipolar disorder?

A
  1. Inhibition of voltage-gated sodium channels - reduces release of glutamate
  2. Increasing action of GABA
  3. Modulates signal transduction cascades and gene expression
  4. May effect neuronal excitation mediated by the NMDA subtype of glutamate receptors
  5. Also effects serotonin, dopamine, aspartate, and t-type calcium channels
62
Q

What is the protein binding for valproic acid?

A

85-90% bound to serum albumin
medications that compete for binding may increase toxicity

63
Q

How is valproic acid eliminated?

A

> 95% hepatic metabolism via glucoronidation, b-oxidation, alpha-hydroxylation

64
Q

What is the therapeutic range for valproic acid?

A

Total(free level) 350-700umol/L (50-150mcg/L)

65
Q

When should you take a valproic acid level?

A

Steady state trough level 3-4 days after initial therapy

66
Q

How is valproic acid dosed?

A

Uses weight based dosing
There can be a loading dose
Empiric maintenance dose generally 250mg BID for bipolar

67
Q

What are the dosing principles for valproic acid?

A

Avoid in hepatic disease
Use lower initial doses in elderly
No dose adjustment necessary for renal impairment

68
Q

What are the common forms of valproic acid?

A

Divalproex sodium (enteric coated tablets)
Valproic acid capsules
Valproate sodium syrup

69
Q

Drug interactions for valproic acid

A

Drugs metabolized by CYP2C9, epoxide hydroxylase, UDPGT
Also subject to displacement interactions with other drugs and endogenous substances (like fatty acids)

70
Q

Which drugs can increase valproate levels?

A

*Antibiotics (macrolides - clarithromycin, erythromycin)
*ASA/salicylates (ASA, salsalate, sodium salicylate)
Anticonvulsants (topiramate)

71
Q

Which drugs can decrease valproate levels?

A

*Antibiotics (carbapenems - ertapenem, imipenem, meropenem)
Anticonvulsants (carbamazepine, phenytoin, phenobarbital)

72
Q

What drugs will valproate increase the concentartaion of?

A

*Lamotragine - very severe interaction, increased by ~50%
Warfarin
TCA’s

73
Q

What are the dose-related AEs of valproic acid?

A

GI(less with VPA): nausea, vomiting, anorexia, diarrhea, constipation
CNS: tremor, sedation, ataxia, dizziness
Thrombocytopenia

74
Q

What are the idiosyncratic AEs of valproic acid?

A

Hepatotoxicity
Pancreatitis
Hyperammonemia
Skin rash (increased risk when combined with lamotragine)

75
Q

What are the chronic AEs of valproic acid?

A

Weight gain (up to 60% of patients, mean 8-14kg)
Menstrual disturbances, polycystic ovaries
Alopecia

76
Q

Can valproic acid be used in pregnancy?

A

No it is teratogenic - can lead to neural abnormalities
Patients need to be on reliable contraception

77
Q

Monitoring parameters for VPA

A

Sedation - ongoing
CBC with diff and platelets, LFTs - baseline, monthly x 3 mo, then q 4-6 months
Ammonia - only if unexplained lethargy/confusion/vomiting
Rash - ongoing
Valproate level - 2-4 days after dose change or interacting drug started then in 1-2 weeks to ensure stable, then as needed

78
Q

Counselling points for valproic acid

A

May take several weeks to see benefit
Check with pharmacist before starting any new medications
Use reliable contraception
Avoid excessive alcohol due to risk of hepatic injury
Can take with food to help with GI upset

79
Q

When is lamotragine indicated in bipolar disorder?

A

Acute bipolar depression
Maintenance in BDI or II
Not a good manic agent

80
Q

MOA of lamotragine

A

Alters signal transduction by binding to open channel conformation of the voltage-gated sodium channels reducing release of glutamate
Weak 5-HT3 receptor inhibitory effects

81
Q

What is important about lamotragine dosing?

A

Titration MUST be done slow to prevent severe rash
Also important to advise patient not to start anything new to rule out other factors

82
Q

Why is adherence important for lamotragine?

A

If you miss a dose for 5 days it would be out of your system and you must restart titration!

83
Q

What would we do if a patient is on VPA/DVP and lamotragine?

A

Reduce dose of lamotragine by 50%

84
Q

AEs of lamotrigine

A

Common: sedation, headaches, nausea, dizziness (all less then with DVP)
Dyspepsia, diarrhea, anxiety, peripheral edema, rash
Rare/serious: risk of SJS, aseptic meningitis, blood dyscrasias (neutropenia), hepatotoxicity

85
Q

DI of lamotrigine

A

*VPA/DVP
Carbamazepine - decrease lamotrigine levels by 30-50%
Oral contraceptives - decrease lamotrigine levels by 50% (should be on a continuous contraceptive, no hormone free week)

86
Q

Counselling points for lamotrigine

A

May take several weeks to see benefit, especially due to slow titration
Adherence is very important
Can take without regards to food or time of day
Self-monitoring for rash is very important - avoid trying new products

87
Q

When is carbamazepine indicated for bipolar?

A

Acute mania treatment
Maintenance

88
Q

MOA of carbamazepine

A

Stimulates release of ADH and potentiates its action in promoting reabsorption of water

89
Q

How is carbamazepine eliminated and what is the major pathway?

A

> 99% hepatic metabolism
Major: CYP3A4
*induces its own metabolism via epoxide-diol pathway (AUTOINDUCTION)

90
Q

What is the target range for carbamazepine?

A

17-51 umol/L

91
Q

When would you take carbamazepine level?

A

Trough within 1 hour prior to dose

92
Q

Dosing principles for carbamazepine

A

Initiate slowly due to early long half-life to minimize side effects
Best to give in divided doses
Best to dose at mealtime
Elderly: Lower initial doses and smaller dose increases
Liver disease: not recommended in decompensated, may need to reduce dose in stable liver disease
Renal impairment: no adjustment necessary

93
Q

What formulations does carbamazepine come in?

A

Oral suspension
Immediate release tablet
Chewable tablets
Controlled release tablets

94
Q

DIs for carbamazepine

A

CYP3A4 inhibitors(increase levels) and inducers(decrease levels)

95
Q

Through was enzyme does carbamazepine induce its own metabolism?

A

CYP3A4

96
Q

What drugs increase carbamazepine levels?

A

Macrolides - erythromycin, clarithromycin
antifungals(azoles) - fluconazole, ketoconazole
CCB - diltiazem, verapamil
* grapefruit juice*
VPA
Lamotrigine
Fluoxetine, trazadone
MAOI - CONTRAINDICATED

97
Q

What drugs are decreased by carbamazepine?

A

MANY
warfarin
DOACs
Antipsychotics
Antidepressants
Methadone
Estrogen or progesterone contraceptives

98
Q

What are the dose-related AEs of carbamazepine?

A

GI: nausea, vomiting, anorexia, dry mouth, constipation
CNS: lethargy, dizziness, sedation, headache, tremor
CV: tachycardia, hypotension

99
Q

What are the idiosyncratic AEs of carbamazepine?

A

SIADH/hyponatremia
Blood dyscrasias
Hepatic: increased GGT, hepatitis
Menstrual disturbances
Weight gain
Photosensitivity
Rash and hypersensitivity reactions

100
Q

carbamazepine should not be taken for patients with which positive genetic test?

A

Asian ancestry - HLA-B1502
Caucasian - HLA-A3101

101
Q

What are the chronic AEs of carbamazepine?

A

Osteomalacia
Vitamin D deficiency

102
Q

When is carbamazepine CI?

A

Hx of hepatic disease
CVD
Blood dyscrasias
Bone-marrow depression
concurrent use with clozapine

103
Q

What monitoring is required for carbamazepine?

A

CBC with diff and platelets, electrolytes, LFT’s, renal function - baseline, then monthly x 3 mo, then q6-12mo
TSH, free T3/T4 - baseline, then q3-6mo
Sedation, tremor, cognitive changes, rash - ongoing
Bone mineral density - if taking for > 5 years

104
Q

Counselling points for carbamazepine

A

Take with food to minimize GI upset
Report rash or flu-like symptoms right away
Recommend copper IUD for birth control
Recommend calcium and vitamin D supplementation
remember to check drug interactions!!

105
Q

Are doses of antipsychotics for bipolar lower or higher then for psychosis?

A

Lower

106
Q

What are the general AEs for antipsychotics?

A

EPS
Hyperprolactinemia, sexual dysfunction
Metabolic disturbances (weight gain, dyslipidemia, DM, CVD)
Anticholinergic: sedation, constipation, dry mouth, blurred vision, confusion
Antihistaminergic: sedation
Alpha1 blockade: hypotension, reflex tachy, dizziness, sedation
QT prolongation
Seizures

107
Q

Should antidepressants be used in bipolar?

A

There is a risk of switching patient to mania but bipolar depression is very difficult to treat.
Avoid AD monotherapy - always in combo with mood stabilizer
Avoid TCAs and SNRIs
Bupropion >sertraline>fluoxetine or other SSRI (not paroxetine) > venlafaxine(?)
Taper off AD once asymptomatic for 6-12 weeks

108
Q

What medications should be discontinued before starting treatment for acute mania?

A

Antidepressants
Stimulants
Alcohol
Nicotine

109
Q

What are the 1st line monotherapy’s for acute mania?

A

Lithium
Quetiapine
Divalproex
Asenapine
Aripiprazole
Paliperidone
Risperidone
Cariprazine

110
Q

What are the first line combo therapies for acute mania?

A

Li/DVP +
- quetiapine
- aripiprazole
- Risperidone
- asenapine

111
Q

When would you expect to see improvements for treatment of acute mania?

A

50% will respond to monotherapy with significant improvement in mania in 3-4 weeks
- some improvement to mania should be seen in first week, especially with DVP or APs

112
Q

What is the benefit of the 1st line combo therapies?

A

Greater efficacy than monotherapy with lithium to DVP alone, especially in more severe illness
- recommended when a response is needed faster, more severe manic episodes, patients at risk, or patients who only had partial response to monotherapy

113
Q

When patient specific factor makes Divalproex a good choice?

A

Comorbid substance use disorder

114
Q

When should a switch or add on therapy be considered for acute mania treatment?

A

If no response is observed within 2 weeks

115
Q

Which agents do not work for acute mania?

A

Gabapentin
Lamotragine - good for depressed side
Omega 3 fatty acids
Topiramate

116
Q

What are the 1st line treatments for bipolar I depression?

A

Quetiapine
Lurasidone + Li/DVP
Lithium
Lamotragine
Lurasidone
Lamotrigine (adj)

117
Q

When do we expect to see a response to treatment for bipolar depression?

A

Can take 4-6 weeks for initial improvement to be observed (and may take longer for full resolution)

118
Q

What is a limitation to trials for quetiapine in acute bipolar depression?

A

The trials were only 8 weeks

119
Q

What agents are NOT recommended for bipolar I depression?

A

Antidepressant monotherapy (unless combined with mood stabilizer)
Aripiprazole
Ziprasidone
Lamotragine with folic acid
Mifepristone adjunctive

120
Q

What are the benefits of effective maintenance treatment early in illness?

A

Reverse cognitive impairment
Preserve brain plasticity
May lead to improved prognosis and minimization of illness progression

121
Q

What are the risk factors for relapses?

A

Younger age of onset
Psychotic features
Rapid cycling
More previous episodes
Comorbid anxiety
Comorbid substance use

122
Q

What is the 1st line non-pharm option for maintenance therapy of bipolar?

A

Psychoeducation - should be offered to all patients as it decreases recurrence rates by ~15%

123
Q

What are the 1st line maintenance therapies for bipolar?

A

Lithium
Quetiapine
Divalproex
Lamotragine
Asenapine
Quetiapine + Li/DVP
Aripiprazole + Li/DVP
Aripiprazole

124
Q

What did the landmark bipolar clinical trial find?

A

Lithium was superior to VPA for maintenance and combo of Li + VPA was favoured over VPA

125
Q

Does lithium or quetiapine have more real world evidence?

A

Lithium

126
Q

If a patient is on combo therapy of lithium + AP when could we consider tapering off the AP?

A

After 6 months if the patient is stable

127
Q

Info for bipolar treatment during pregnancy

A

Avoid: DVP/VPA, CBZ
Small increased risk in 1st trimester: Li
Least risk/appears safe: lamotragine
APs: least studied but risk appears neutral for quetiapine, risperidone, aripiprazole, olanzapine

128
Q

Which medication has the most evidence for suicide prevention?

A

Lithium

PHAR 358 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions