Mood Stabilisers

Question 1

What are some examples of anticonvulsants?

Answer 1

Sodium valproate, carbamazepine, lamotrigine

Question 2

What are the types of drugs you can use as mood stabilisers?

Answer 2

Lithium, anticonvulsants, 2nd generation antipsychotics (quetiapine common)

Question 3

What are the issues with using Lithium as a mood stabiliser?

Answer 3

1. Narrow therapeutic range - regular blood monitoring required, toxicity (ataxia, nausea, vomiting, tremor)
2. Side effects - negative effects on thyroid, kidneys and heart
3. Harmful to foetus - Ebstein’s anomaly

Question 4

What is the mechanism of action of carbamazepine and sodium valproate?

Answer 4

Increase amount of GABA released by acting as an agonist at Na-voltage gated channels

Question 5

What side effects are sodium valproate, carbamazepine and lamotrigine associated with individually?

Answer 5

1. Sodium valproate - liver failure and weight gain
2. Carbamazepine - bone marrow suppression
3. Stevens-Johnson syndrome

Question 6

What are the effects of sodium valproate and carbamazepine on pregnancy and how is it negated?

Answer 6

Harmful to foetus, causes neural tube defects.

Prophylactic folic acid prescribed 5mg daily from at least a month before conception.