Mood stabilizer

Question 0

Valproic Acid /Divalproex

Answer 0

Mood stabilizer: Acute mania, schizoaffective, lithium nonresp, combo w/ lithium, borderline personality.
Anti-convulsant: prolongs Na+ ch inactivation, dec Ca++ current
Migraine prophylaxis
Hepatotoxic, preg Cat. D (switch to Li), SJS (important), GI, Wt gain, alopecia.

Question 1

Lithium

Answer 1

Mood stabilizer
Renal excretion
Inc toxicity w/ low Na+, thiazides, NSAIDs. Inc mania w/ antidepressant
Hypothyroidism, DI (tx w/ amiloride). Dose adjustment for pregnancy

Question 2

Lithium OD

Answer 2

Discontinue drug
Infuse Na+
Hemodialysis, gastric lavage
Anti-epileptic meds

Question 3

Carbamazepine

Answer 3

Mood stabilizer - for Li non responders
Anti-convulsant - prolongs Na inact, partial and gen tonic clonic
Trigeminal neuralgia (high dose)
P450 inducer (own met), blood dyscrasias, test HLAB1502, SJS
Preg Cat D