Drugs - Lithium 01 Flashcards
What is sufficient for a diagnosis of bipolar disorder?
The presence of mania alone
What is the minimum amount of time to qualify for a depressive episode?
Two weeks
What is a recurring feeling of variability and inflated self-esteem lasting over four days called?
Hypomanic episode. It is similar to a manic episode but the symptoms are less severe and no delusions or hallucinations
What is a period of heightened and irritable mood levels lasting for at least one week called?
Manic episode
No sign of fatigue is seen in which type of episode, hypomanic or manic?
Hypomanic
What is also known as dysphoric mania or agitate depression?
A mixed episode
Tearfulness during a manic episode or racing thoughts during a depressive episode or typical examples of what?
A mixed episode
What is a bipolar illness associated with the chronic recurrence of mania and depression at least four times in one year called?
Rapid cycling
Is rapid cycling more likely in men or women?
Women
What is a major difference between bipolar I and II disorders?
Bipolar I has full-blown manic episodes versus Bipolar II which will have hypomania
What is lithium used to treat?
- Acute manic episodes and possibly some unipolar depressive states
- prophylaxis of both manic and depressive episodes
- treatment of alcoholism or depression is a major component of the disorder
- management of violence and aggression, explosive personalities, and emotionally unstable character disorders
What are the modes of action of lithium?
1 - inhibits the depolarization evoked and calcium -dependent release of dopamine and norepinephrine but not serotonin from nerve terminals
2 - inhibits norepinephrine sensitive adenylyl cyclase
3 - inhibits glycogen synthase kinase-3 that appears to limit neurotrophic and neuroprotective processes
4 - inhibits the removal of the phosphate group from monophosphoinositol (IP) to generate inositol (I). Use of the PIP2 system
What are other neurotransmitters that use the PIP2 system?
- Odd number muscarinics (M1, M3, M5)
- 5HT2 subtypes
- Alpha-1
- H1
so lithium has a shotgun approach to treating manias by depleting PIP2 (by inhibiting the salvage pathway to regenerate PIP2) which will have a profound effect on these neurotransmitter systems.
Besides lithium which of the two antipsychotic drugs inhibit the PIP2 system?
Valproic acid and carbamazepine
What cleaves PIP2 into DAG and IP3 and is also turned on by DAG?
Phospholipase C
