Mood stabalisers

Question 1

4 indications for lithium

Answer 1

1) prophylaxis for bipolar
2) manage manic episodes
3) prophylaxis in recurrent depression
4) prophylaxis in schizoaffective disorder

Question 2

Onset of lithium

Answer 2

7-14 days

Question 3

Baseline tests for lithium (8)

Answer 3

Weight, BP, pulse 
Renal function 
FBC 
U&E
TFT
Base line ECG

Question 4

Check for what in the neck before starting lithium?

Answer 4

goitre

Question 5

4 important drug interactions with lithium

Answer 5

ACE
Diuretics
NSAIDS
SSRIs

Question 6

4 contraindications for lithium

Answer 6

1) Cardiac disease
2) Significant renal impairment
3) Addison’s disease
4) Untreated hypoT

Question 7

In which stage of pregnancy should lithium be avoided?

Answer 7

1st

Question 8

Lithium - very important point in terms of prescribing

Answer 8

prescribe by brand

Question 9

Important advice on medication for patients on lithuium (interaction)

Answer 9

don’t take with NSAIDs

Question 10

Alcohol advice with lithium

Answer 10

1-2 units p/day max

Question 11

How long does it take to establish on lithium?

Answer 11

3-6 months

Question 12

Blood levels checked?

Answer 12

@12hrs
@ 5 days
then weekly until 4 weeks stable
then every 3 months

Question 13

6 SE of lithium

Answer 13

Abdo pain 
Nausea 
Metallic taste (usually wears off) 
Fine tremor 
Thirst and polyuria 
Weight gain and oedema

Question 14

Advice on withdrawal

Answer 14

Don’t stop suddenly

Question 15

Sodium valproate pre questions

Answer 15

Pregnant / trying for a baby / breast feeding?

Liver or kidney problems?

Question 16

What should SV be taken with?

Answer 16

after meals

Question 17

No. of doses per day for SV

Answer 17

2-3 tablets

Question 18

Alcohol and SV

Answer 18

none

Question 19

Medication to avoid with SV

Answer 19

aspirin

Question 20

SE of SV (8)

Answer 20

Nausea 
Stomach ache 
Diarrhoea 
Headache 
Increased appetite and Weight gain 
Feeling tired 
Hair thinning

Question 21

Regular blood checks for what when on SV?

Answer 21

Liver

Question 22

How long is SV taken in bipolar?

Answer 22

usually life long

Question 23

Lithium toxicity effects two systems

Answer 23

GI and Neuromuscular

Question 24

Lithium GI toxicity presents as?

Answer 24

anorexia, diarrhoea and vomiting

Question 25

Lithium neuromuscular toxicity presents as?

Answer 25

Dysarthria, dizziness, ataxia, muscle twitches, tremor and co-ordination problems.