Lithium

Question 1

Name the mood stabilizers

(“stabilizing ski poles”)

Answer 1

Lithium (“lifthium lift”)

Valproate (“winter festiVAL”)

Carbamazepine (“classic car carved in ice”)

Lamotrigine (“kid on dads head wearing Llama outfit”)

Antipsychotics (“psychotic painting on high peak”)

Question 2

what is lithium useful for ?

(“lifthium lift”)

Answer 2

• lithium can treat bipolar disorder ​
• acute mania and maintenance

(“stabilizing chair lift” on “lifthium lift”)

Question 3

what are the side effects of lithium

Answer 3

-has very narrow therapeutic index
(“narrow window of opportunity to get off chair LIFTHIUM”)

-lithium therapy can cause hypothyroidism
(“pinguine on snowboard has undone bowtie”) which presents with :

• weight gain (“fat ass snowboarder”)
• ​dry skin
• ​hair loss
• ​constipation

-lithium can cause nephrogenic diabetes insipidus (“insipidus peeing kid fountain”)

-diuretics like thiazide and NSAIDs→ decrease GFR and clearance of lithium therefore increase lithium levels
(“kid thighs on high dive” and pole saying “low clearance”)

-lithium is teratogenic and can cause Ebsitein’s anomaly (“tarantula hat on yellow shirt girl”)

• atrialization of the right ventricle occurs as well as ASD and tricuspid valve defects
  (“large right snow head looks defected”)

acute lithium toxicity

• causes GI symptoms [nausea , vomiting ,diarrhea]
  (“early nauseated green shirt kid” )

chronic lithium toxicity

• neurologic symptoms-tremor
  (“late trembling blacky girl”)
• neurologic symptoms-ataxia
  (“late falling black kid”)

Question 4

what other drugs can be used to treat bipolar disorder?

Answer 4

Valproate (“winter festiVAL” sign)

• acute mania and maintenance

Carbamazepine (“classic car carved in ice”)

• acute mania and maintenance

1st [Haloperidol] and 2nd [Quetiapine] antipsychotics
(“psychotic paintings on high peak”)

• acute mania

Lamotrigine (“child and dad wearing Llama outfit”)

• maintenance only