Mood Disorders Flashcards
1
Q
Antipsychotic
- For use in euphoric mania/rapid cyclic/maintenance therapy in bipolar disorders
- Alters cation transport in nerve and muscle
- Adverse Effects: GI effects, tremors, renal toxicity, seizures, abnormal thyroid function
- Normal therapeutic level: 0.4-1.0
- Use with caution in patients with low sodium levels, as low sodium increases toxicity
A
Lithium
2
Q
Antipsychotic/Anticonvulsant
- Maintenance therapy for BD
- Affects sodium ion transport and enhances GABA
- Adverse effects: Rash, GI effects, dizziness, headache, sedation (taken at bedtime)
- Assess for rash at each visit
A
Lamotrigine
3
Q
Antipsychotic/Anticonvulsant
- Acute mania/mixed mood/comorbid substance use/multiple prior episodes
- Affects ion transport and enhances GABA
- Adverse effects: GI effects, weight gain, hepatotoxicity, thrombocytopenia
- If using with lamotrigine, decrease levels by 50%
A
Valproic acid
4
Q
Second-generation antipsychotic
- Acute BD, acute manic/mixed episodes, bipolar maintenance
- Second-generation antipsychotics are dopamine, norepinephrine, and serotonin receptor antagonists
- GI effects, weight gain, sedation, hyperglycemia,** blood dyscrasias**
- Monitor for EPS
A
Risperidone
5
Q
Anticonvulsant/antipsychotic
- Acute mania/mixed mood
- Blocks glutamate voltage-gated sodium and calcium channels
- GI effects, sodium, hyponatremia, neutropenia, SJS, hepatotoxicity, renal impairment
- Monitor plasma drug levels, sodium levels, renal and liver function, and check for blood dyscrasias
A
Carbamazepine
6
Q
High-potency first-generation antipsychotic
- Used in schizophrenia and acute psychosis
- Early extrapyramidal reactions (acute dystonia, parkinsonism, akathisia) occur frequently, whereas sedation, hypotension, and anticholinergic effects are uncommon
- Can prolong the QT interval and hence may pose a risk for serious dysrhythmias, especially when given by the IV route or in high doses
A
Haloperidol
7
Q
Second-generation antipsychotic
- Antipsychotic effects result from blockade of receptors for dopamine and serotonin (5-hydroxytryptamine [5-HT])
- Common adverse effects include sedation and weight gain (from blocking H1 receptors); orthostatic hypotension (from blocking α-adrenergic receptors); and dry mouth, blurred vision, urinary retention, constipation, and tachycardia
- Risk of fatal agranulocytosis and metabolic effects
- Risk of EPSs is low in second-generation
A
Clozapine
8
Q
SSRI
- SSRIs selectively block neuronal reuptake of serotonin (5-hydroxytryptamine [5-HT]), a monoamine neurotransmitter
- The concentration of 5-HT in the synapse increases, causing increased activation of postsynaptic 5-HT receptors
- The most common side effects are sexual dysfunction, nausea, headache, and manifestations of CNS stimulation, including nervousness, insomnia, and anxiety
- Can elevate plasma levels of TCAs and lithium
A
Fluoxetine
9
Q
SNRI
- Powerful blockade of NE and 5-HT reuptake and weak blockade of dopamine reuptake
- Most common is nausea (37% to 58%), followed by headache, anorexia, nervousness, sweating, somnolence, and insomnia
- Can also cause dose-related sustained diastolic hypertension; sexual dysfunction; sustained mydriasis
A
Venlafaxine
10
Q
TCA
- Block neuronal reuptake of two monoamine transmitters: NE and 5-HT
- Therapeutic uses: depression, fibromyalgia syndrome, neuropathic pain, ADHD
- Orthostatic hypotension, sedation, and anticholinergic effects; most serious adverse effect is cardiotoxicity
- Cause direct blockade of receptors for histamine, acetylcholine, and NE
A
Imipramine/Amitriptyline/Doxepin
11
Q
Atypical antidepressant
- Stimulant actions and suppresses appetite
- May be related to blockade of dopamine or NE reuptake
- Appears to increase sexual desire and pleasure
- Generally well tolerated but can cause seizures; contraindicated in patients with bulimia
A
Bupropion
