Bipolar drugs Flashcards
Lithium can be used to treat which phases of Bipolar?
-Mania, Depression, Maintanence
Lamotrigine can be used to treat which phases of Bipolar?
- Depression, Maintenance
Divalproex can be used to treat which phases of Bipolar?
- Mania, maintenance
Acute Side effects of Lithium
1) tremor
2) thirst, increased urination
3) N&V
4) dizziness, drowsiness
Chronic Side effects of lithium
1) Derm: Acne, psoriasis
2) Weight gain
3) Hypothyroidism
4) Heart arrhythmia
5) Hyponatremia
6) Benign decreases in WBC
Monitoring
1) Blood levels (q3-6 months after stable condition)
2) Thyroid levels
3) Fluid loss when have vomiting or diarrhea
* **4) Maintain usual salt and caffeine intake! Decreased sodium intake could increase Lithium levels b/c of decreased lithium clearance.
5) Renal function b/c excreted by kidney (controversial effect on glomerular)
6) ECG in patients with cardiovascular disease.
Interactions
ACEI, NSAID’, thiazides could increase lithium toxicity
Lithium Toxicity
1) tremor
2) N&V
3) dizziness
4) loss of consciousness.
5) slurred speach
Drugs to treat acute mania
1) Lithium
2) Divalproex
3) SGA
4) Lithium + SGA
5) Divalproex +SGA
Drugs for maintenance
1) Lithium
2) Divalproex
3) Lamotrigine
4) olanzapine
Drugs for depression
1) Lithium
2) Lamotrigine
3) Quetiapine.
4) Lihtium + Divalproex.
Who qualifies for maintenance therapy
1) Severe episode
2) Two or more episodes
3) Frequent episodes
4) family history
5) Rapid onset
Difference between Bipolar I and II
1) Bipolar I has to include at least 1 Mania episode with or without depressive episodes
2) Bipolar II has to include at least 1 HYPO mania episode with at least 1 depressive episode.
Criteria for Bipolar Disorder
Elevated Mood and Irritable Mood
Need at least 3 of the below for 1 week (without treatment):
1) Excessive involvement in pleasurable activity
2) Easily distracted.
3) Visions of Grandeur
4) Flight of Ideas
5) Energized even though have lack of sleep
6) More talkative
7) More goal oriented activity
How should therapy be discontinued
Tapered down slowly to prevent withdrawal symptoms
