Mood stabilisers + anxiolytics

Question 1

Valproic acid

Answer 1

Inhibits voltagte gated sodium channels, increases GABA

CI in pregnancy - spina bifida

Hepatic necrosis

Question 2

Lithium

Answer 2

Initially used for gout
Was incorporated into 7up

Anti-suicide effects

Low therapeutic index

LMNOP - lithium SE - movement (tremor) - nephrotoxicity - hypOthyroidism (x6 increase)- pregnancy problems

Question 3

Carbamazepine

Answer 3

inhibits voltage gated sodium channels, augments GABA transmission

Risk of agranulocytosis

Question 4

Lamotrigine

Answer 4

Inhibits voltage gated sodium channels, does not effect GABA (more helpful for depressive episodes)

Itchy rash common

SJS (mucus membrane involvement), 1:1000

Question 5

Topiramate

Answer 5

NOT a mood stabiliser

Weight loss, word finding difficulties, kidney stones, metabolic acidosis

Question 6

Anxiolytics

Answer 6

Benzos - increase frequency that GABA channels open

Barbiturates - increase length of time GABA channels stay open

Question 7

Benzos

Answer 7

Short (1-12 hr half life) - triazolam, oxazepam, midazolam

Medium (12-40) - clonazepam, alprazolam, lorazepam, temazepam

Long (40-250) - diazepam, chlordiazepoxide

Question 8

Buspirone

Answer 8

SE, DA

May take several weeks to kick in

Question 9

Zolpidem

Answer 9

Anterograde amnesia, sleep walking