Drugs - Lithium 03

Question 1

How is lithium used in the treatment of severe acute mania?

Answer 1

Lithium or Valproate + an antipsychotic (avoid ziprasidone)

Question 2

How is lithium used in the treatment of hypomania or mild to moderate mania?

Answer 2

Monotherapy with risperidone or olanzapine

Question 3

How is lithium used in the treatment of bipolar depression?

Answer 3

Combine it with an antidepressant (but avoid monotherapy in manic episodes, mixed states, and bipolar I patients)

Question 4

What is the maintenance therapy for bipolar disorder?

Answer 4

First line:

• lithium (reduced risk of suicide)
• valproate
• lamotrigine
• risperidone long-acting injection