L8 - Mood stabilisers

Question 1

Two main types of bipolar disorder?

Answer 1

Bipolar Disorder I: People with this type of bipolar disorder are more likely to experience mania for longer periods of time and experience psychotic symptoms.
- depressive, manic and mixed episodes

Bipolar Disorder II: People with this type of bipolar disorder do not experience psychotic symptoms and generally have episodes of mania that last for a short time e.g. hours or at most, a few days.
- depressive and hypomanic episodes

Question 2

bipolar 1/2?

Answer 2

schizobipolar disorder

positive symptoms of psychosis with manic, hypomanic and depressive episodes.

Question 3

what is antidepressant poop out

Answer 3

edical condition in which progressive or acute tolerance effects are seen following chronic administration of a drug

Question 4

ECT for mania?

Answer 4

EFFECTIVE

80% response rate

Question 5

Lithium?

Answer 5

used for ACUTE MANIA

reduces hyperative dopamine systems

• first line treatment, but response rate is 7-80% in 3 weeks
• discontinuation in less than 2 years is associated with recurrence
• prevents bpolar affective disorder
• very much better than placebo
• prevents depression in general
• also used as adjunctive treatment in schizophrenia and schizoaffective disorder.

Question 6

name some mood stabilisers

Answer 6

lithium
valproate
carbamazepine
- antipsychotucs

Question 7

What is hyperactive in mania?

Answer 7

DOPAMINE systems

Question 8

side effects of lithium ?

Answer 8

earlier - metallic taste, nausea, constipation, diarrhoea, weight gain, therist

intermediate - tremor, hyper/hypothyroidism, polyuria

late - renal impairment

??? so maybe an antipsychotic could be better.. probably the same efficacy as lithium

Question 9

Valproate and Carbamazepine?

Answer 9

use in in patients unresponsive to, or intolerant of, lithium

 Valproate far more effective than carbamazepine

 Especially useful in rapid cycling BPAD
 Acute treatment of mania
 Useful as second mood stabiliser (as effective as adding an antidepressant)
 Adding an antidepressant (SSRI) should not be used on its own due to the increased likelihood of inducing mania or rapid cycling, but preferred for break through depression
 Adjunctive treatment of schizophrenia

Question 10

What is the mechanism for antipsychotics

Answer 10

reducing Glutamate hyperactivity with atypical antipsychotic

Question 11

1st line treatment for bipolar?

Answer 11

LITHIUM
MOOD STABILISER
SDA - serotonin dopamine antagonist
DPA

Question 12

1st line treatment for scz?

Answer 12

dpa

sda

Question 13

Comorbidities in bipolar?

Answer 13

anixety disorder
dugs and alcohol
psychosis
aggression
adhd
Borderline