Drugs for Bipolar Disorder Flashcards
Major depressive disorder (MDD)/ unipolar depression
- Chronic depressed mood
- Comorbid with anxiety disorders
- high lifetime prevalence (approx. 15-20%).
Bipolar disorder
- Patient experiences alternations of mania and depression.
- Three types depending on the amount of time a person spends in mania, and the severity of the symptoms.
Bipolar Disorder Type 1
in which the primary symptom presentation is manic, or rapid (daily) cycling episodes of mania and depression.- more mania than type 2
- maina lasts at least 7 days
Bipolar Disorder Type 2
in which the primary symptom presentation is recurrent depression accompanied by hypomanic episodes (milder state of mania)
Cyclothymic Disorder
a chronic state of cycling between hypomanic and depressive episodes that do not reach the diagnostic standard for bipolar disorder (less severe symptoms).
Manic episodes are characterized by:
1) distinct period of abnormally (at least 1 week)
2) During the period of mood disturbance, three (or more) of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree
Heritability of MDD
70-80%
Heritability of BPD
1-2%
Comorbidities of BPD
ADHD, anxiety disorder, substance abuse, obesity and metabolic syndrome (T2D, cardiovascular disease, dyslipidemia).
Treatment strategies for BPD
mix of mood stabilizers, antipsychotics, and antidepressants.
polypharmacy
many drugs to treat multiple symptoms
Most commonly prescribed mood stabilizers
lithium and valproate
Mechanism of lithium
UNKNOWN
but appears to block downstream signaling events that occur when dopamine receptors are activated) . High effects causes therapeutic effects but has risk for kidney damage
3 Anticonvulsant mood stabilizers
valproic acid
lamotrigine
carbamazepine
Mechanism of valproic acid
UNKNOWN
Valproate blocks voltage-gated sodium channels- required to propagate action potentials along the axon
