Mood Stabilizers

Question 0

Inhibits inositol signaling through depletion of intracellular inositol
Inhibits glycogen synthase kinase-3 in signaling via insulin-like growth factor, BDNF, and Wnt pathway (energy metabolism pathways that provide neuroprotection and increase neuroplasticity)
Closely related to sodium and can substitute in generating action potentials
Adverse: polyuria, subclinical hypothyroidism, nausea, tremor, choreoathetosis, ataxia, diabetes insipidus, edema, sick sinus syndrome

Answer 0

Lithium

Eskalith

Question 1

Anticonvulsive that inhibits seizures by reduction of recovery time of Na+ channels and reduction of low threshold T-type Ca2+ currents; may also inhibit GABA degradation enzymes
Depletes inositol
Toxicity: transient GI symptoms, anorexia, nausea, vomiting, sedation, ataxia,tremor, rash, alopecia, weight gain

Answer 1

Valproic acid

Depakene

Question 2

Anticonvulsive that decreases the rate of recovery for sodium channels preventing firing
Used for partial and tonic-colonic seizures; can also be used as a mood stabilizer in bipolar disorder
-can increase its own metabolism over time
Adverse: stupor, coma, hyper irritability, convulsions, resp depression, drowsiness, diplopia, vertigo, ataxia, aplastic anemia, agranulocytosis
Interactions: oral contraceptives, phenobarbital, phenytoin

Answer 2

Carbamazepine

Tegretol

Question 3

Treatment plan for bipolar disorder

Answer 3

-valproic acid can be used as first line in early treatment for manic phase -> just as effective as lithium
-carbamazepine can be used if lithium not working for mania
-other drugs for manic phase of bipolar 1:
olanzapine, aripiprazole, chlorpromazine, quetiapine, risperidone, ziprasidone