module 4 mood disorders Flashcards
Manic episodes with or without psychosis and/or major depression
Bipolar 1
Hypomanic episode with major depression; no history of manic or mixed episode
Bipolar 2
hypomanic and depressive symptoms that do not meet criteria for bipolar 2 disorder; no major depressive episodes
cyclothymia
Does not meet criteria for MDD, Bipolar 1 or 2, or cyclothymia
Bipolar disorder not otherwise specified
Add to mood stabilizer during manic episode
antipsychotic
Do not give antidepressants in patients with bipolar
True
Lithium level therapeutic index
0.5-1.5 mEq/L
Signs of lithium toxicity
Movement (Tremor)
Nephrotoxicity
HypOthyroidism
Pregnancy problems
Labs to monitor with lithium
Lithium level electrolytes creatinine and BUN CBC TSH/thyroid panel Pregnancy test
Inhibits voltage-gated sodium channels
Increases GABA
Valproic Acid (Depakote) Carbamazepine (Tegretol)
contraindicated in pregnancy
Decreases folate
Depakote (Valproic Acid)
Side Effect of fatal hepatic necrosis
Depakote
Risk of agranulocytosis
Carbamazepine (Tegretol)
Inhibits sodium channels but does not effect GABA
Lamictal (lamotrigine)
Better for use in patients with mood disorders without mania because it does not increase GABA
Lamictal
Side effect of Lamictal
Rash
Can progress to Steven Johnson Syndrome
Off-label anticonvulsant sometimes used for mood stabilization
topiramate (Topamax)
Enhance GABA by increasing frequency of opening GABA receptors
Benzodiazepines
Enhance GABA by increasing the duration of opening of GABA receptors
Barbituates
short-acting benzos
1-12 hour half life
Triazolam
Oxazepam
Midazolam
Medium-acting benzos
12-40 hour half life
Clonazepam
Alprazolam
Lorazepam
Temazepam
Long-acting benzos
40+ hour half life
Diazepam (Valium)
Chlordiazepoxide (Librium)
