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Psychiatry AM > Mood stabilisers > Flashcards

Mood stabilisers Flashcards

1
Q

What are the indications for mood stabilisers?

A

Bipolar
Cyclothymia
Schizoaffective

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2
Q

What are the classes of mood stabilisers?

A

Lithium
Anticonvulsants
Antipsychotics

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3
Q

What is lithium good for?

A

Effective long term prophylaxis of mania and depressive episodes

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4
Q

What are the factors predicting a positive response to lithium?

A

Prior long term response or FH of good response
Classic pure mania
Mania followed by depression

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5
Q

What baseline tests should be done to prescribe lithium?

A

U&E, TSH

Pregnancy test

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6
Q

What is the goal level of lithium?

A

0.6-1.2

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7
Q

What are the side effects of lithium?

A 
GI distress0 reduced appetite, N&V, diarrhoea
Thyroid abnormalities
Polyuria, polydipsia
Hair loss
Acne
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8
Q

What are the signs and symptoms of mild lithium toxicity?

A

D&V
Dizziness
SLurred speech

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9
Q

What are the signs and symptoms of a moderate lithium toxicity?

A 
N&V
Blurred vision
Clonic limb movements
Convulsions
Delirium
Syncope
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10
Q

What are the signs and symptoms of severe lithium toxicity?

A

Generalised convulsions
Oliguria
Renal failure

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11
Q

What anticonvulsants are used as mood stabilisers?

A

Valproic acid
Carbamazepine
Lamotrigine

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12
Q

What are the uses valproic acid?

A

Mania prophylaxis

Depression prophylaxis- not as effective but better tolerated than lithium

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13
Q

What factors predict a positive response to valproic acid?

A

Rapid cycler
Mixed patient
Comorbid substance issues
Comorbid anxiety

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14
Q

What tests should be done before prescribing valproic acid?

A

LFTs, FBC

Pregnancy test

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15
Q

What is the target level of valproic acid?

A

50-125

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16
Q

What ar the side effects of valrpoic acid?

A 
Thrombocytopenia
Platelet dysfunction
N&V
Weight gain
Sedation
Tremor
Hair loss
17
Q

What are the indications for carbamazepine?

A

1st line in acute mania and mania prophylaxis

Rapid cyclers and mixed patients

18
Q

What tests shouldd be done before prescribing carbamazepine?

A

LFTs, FBC, ECG

19
Q

What is the target level of carbamazepine?

A

4-12

20
Q

What are the side effects of carbamazepine?

A 
Rash
N&V, diarrhoea
Dedation
Dizziness
Ataxia
Confusion
21
Q

What are the drug interactions pf carbamazepine?

A 
SO MANY
REMEMBER
COntraceptic pill
Warfarin
Many psychotropics
22
Q

What are the side effects of lamotrigine?

A 
N&V
Sedation
Dixxiness
Ataxia
Confusion
Toxic epidermal necrosis and Stevens Johnsons- stop if any rash develops
23
Q

What are the drug interactions of lamotrigine?

A

Valproic acid

Sertraline

Psychiatry AM (16 decks)

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