Bipolar meds

Question 1

Valproic Acid, Divalproex (Depakote)

Answer 1

-anticonvulsant
-helps manic or mixed episodes
-monitor serum levels

Question 2

Lithium

Answer 2

-gold standard for bipolar management, acute mania
-monitor blood levels monthly, good range is 0.8
-patients need to consume consistent amounts of Na and water (dehydration and hyponatremia can cause toxicity)

-early signs of toxicity: 1.5, n/v/d, thirst, polyuria, lethargy, slurred speech, fine tremor, muscle weakness, blurred vision

-advanced signs: 1.5-2, coarse hand tremor, GI upset, mental confusion, muscle irritability, EEG changes, sedation, incoordination

severe signs: 2-2.5, ataxia, giddiness, serious EEG changes, blurred vision, clonic movements, large output of diluted urine, seizures, stupor, severe hypotension, coma, death, >2.5= convulsions, oliguria, death

Question 3

Carbamazepine (Tegretol)

Answer 3

-anticonvulsant
-decreases synaptic transmission of excitatory neurotransmitters=stabilize mood fluctuations

Question 4

Lamotrigine (Lamictal)

Answer 4

-anticonvulsant
-risk for Steven Johnson’s syndrome, must start slow and titrate
-considered a safer mood stabilizer for preg

Question 5

Atypical antipsychotics

Answer 5

-help with manic and depressive episodes
-block dopamine and affect serotonin
-aiding in mood balance

Question 6

Antidepressants

Answer 6

-SSRIs (Fluoxetine (Prozac), sertraline (Zolaf)) and SNRIs (Venlafaxine (Effexor), duloxetine (cymbalta))
-use cautiously along mood stabilizers to manage depression due to risk of manic episode, especially in SNRIs
-facilitate mood regulation