Mood Stabilisers Flashcards
What is bipolar 1?
What is bipolar 2?
What should you check if you suspect bipolar?
abnormally different
Hypomanic, grand, irritable, elevated mood.
Thyroid function. Substance misuse.
What are the first line medications used for bipolar?
Lithium, Olanzapine and Valproate
What should you prescribe for rapid cycling?
What is the other name for Valproic Acid?
What is the other name for Sodium Valproate?
Valproate
Depakote
Epilim
What is the dosage of valproate?
750mg in divided doses to 1-2g. (Both epilim and depakote).
What are the side-effects of Valproate?
Which has the lowest Valproate levels, Depakote or Epilim?
Gastro-intestinal and hair loss.
Depakote.
What are the symptoms of bipolar depression?
When should you avoid antidepressants?
Irritability, guilt, feeling restless, weight gain, sleeping a lot, moving slowly.
In rapid cycling.
What dose of SSRI should you use?
What would you consider if SSRI not working?
What is the risk with TCAs
Minimum therapeutic dose.
Mirtazepine or Venlafaxine.
More risk of switching.
When would you use Lamotrigine?
What are the dosages?
Bipolar Depression.
25mg for 14 days initially up to 200mg maintenance.
What are the dosages of Olanzapine?
What are the side effects?
5mg - 20mg
Weight gain.
If not using Olanzapine, what other antipsychotics would you use?
Which are black triangle or less suitable?
Quetiapine, Risperidone.
Aripiprazole, Asenapine.
What are the side-effects of Lithium?
what are the signs of overdose?
What is Lithium protective in?
Gastro-intestinal, Fine Tremor.
tremor, ataxia, renal impairment, convulsions.
Suicidality.
What are the normal blood levels of lithium?
When should bloods be taken?
What can high levels lead to and how many mmol/litre can be fatal.
0.6 - 0.8mmol/litre
12 hours post dose.
Hypothyroidism. 1.5mmol/litre.
When would you prescribe Carbamazepine?
What is the dosage of Carbamazepine?
What symptoms indicate that you should stop Carbamazepine?
If unresponsive to Lithium.
600mg - 1.6g.
Rash, headache, fever - auto-immune response.
Should you increase Carbamazepine if relapse?
What is Carbamazepine an inducer of?
No. Add an antipsychotic.
other medications.
What system in the body may lithium affect?
What drugs should you avoid if taking lithium?
How would you know if there are renal problems.
Renal.
Diuretics.
Createnine 1.5 +
What is the dosage of Lithium?
What other drugs should you avoid with lithium?
400mg - 1.2g
NSAIDs, ace-inhibitors.
What anxiolytic would you use initially in behavioural disturbance or agitation?
Lorazepam.
Which drug should not normally be prescribed for women of childbearing potential?
Valproate/Valproic acid/semi-sodium valproate.
Lithium is used for treatment of mania, hypomania and depression in bipolar disorder and in the treatment of recurrent unipolar depression.
What disorder is lithium associated with.
What medications can add risk to the use of lithium?
Thyroid and mild cognitive impairment.
NSAIDS, ACE inhibitors or diuretics.
What else can lithium be prescribed for?
self-harming and aggressive behaviour.
