Mood stabilizers

Question 1

what are the common mood stabilizers

Answer 1

Lithium
valproic acid (depakote)
carbamazepine
gabapentin (neurontin)
lamotrigine

Question 2

Indications for mood stabilizers

Answer 2

BIPOLAR and chronic low grade bipolar (cyclothymia)
tx resistant DEPRESSION
agitation in DEMENTIA
SCHIZOPHRENIA

Question 3

Tells patients to watch out for these indications of lithium toxicity (ACRONYM). Drugs to caution with? What to do it symptoms?

Answer 3

high Li+ = low Na+.
CAUTION diuretics and NSAIDS
Confusion, Ataxia, Nausea, Tremor (CAN’T)
ED: STAT lithium level > 3 = dialysis

Question 4

first line for bipolar today. SA?

Answer 4

depa coat DEPAKOTE or Valproate (SAT)

• sedation
• ataxia
• thrombocytopenia**

Question 5

routine labs (3) with depakote (valproate) and possibly A

Answer 5

Regularly: 1) CBC (thrombocytopenia*)

2) LFTs
3) Valproate level

A) pancreatitis

Question 6

routine labs (3) with carbamazepine (tegretol)

Answer 6

1) CBC (thrombocytopenia*)
2) LFTs
3) carbamazepine level

Question 7

Gabapentin (neurotin) in comparison to Lithium, Depakote, Carbamazepine? sometimes useful with what condition?

Answer 7

well tolerated but maybe less effective.

sometimes useful in agitation for dementia

Question 8

very popular mood stabilizer with what dangerous SA?

How to RX?

Answer 8

Lamotrigine…Lam o tra gene (Lamictal)
STEVENS JOHNSON life threatening rash
Start low dose, titrate SLOWLY