Mood stabilisers Flashcards
mood stabiliser drugs
lithium
Valproate
LAmotrigine
Carbamazepine
Which atypical antipsychotics have mood stabilising effects
Quetiapine, Olanzapine and aripiprazole
When is prophylaxis used for bipolar disorder
Single manic episode associated with significant risk
Illness with significant impact on functioning
Two or more acute episode
When is lithium indicated
Acute mania/hypomania (good evidence)
Prophylaxis in bipolar disorder
Bipolar depression
Treatment-resistant depression
Side effects lithium
GI upset Fine tremor Polyuria Polydipsia Metallic taste in mouth Weight gain Oedema
Toxicity of lithium associated with
low sodium diets, dehydration, drug interactions (NSAIDS, ACE inhibitors, thiazide and loop diuretics) and some physical illnesses such as Addison’s disease
Symptoms of toxicity of lithium
Diarrhoea Course tremor Ataxia Dysarthria Nystagmus Confusion Convulsions
Monitoring of lithium
Checking regular lithium levels (once every 3 months)
U&E
TFT
When is valproate indicated
Acute mania/hypomania
Prophylaxis in bipolar disorder (weaker evidence than lithium)
Mechanism of action of lithium
valproate inhibits catabolism of GABA, alters synaptic plasticity, promotes BDNF expression and reduces levels of protein kinase C.
Lamotrigine indications
Bipolar depression
Prophylaxis in bipolar disorder (limited evidence)
Augmentation of antidepressants in treatment-resistant depression
Side effects of lamotrigine
Stevens-Johnson syndrome
Possibility an increased risk of cleft lip/palate
Mechanism of action of carbamazepine
Voltage dependent sodium channels
Carbamazepine indicated in
Acute mania/hypomania (weaker evidence than lithium or valproate)
Prophylaxis in bipolar disorder (weak evidence)
Bipolar depression
