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Psychopharm > Mood stabilizers > Flashcards

Mood stabilizers Flashcards

1
Q

What are the 7 mood stabilizers?

A
  1. Lithium
  2. Carbamazepine
  3. Valproic acid
  4. Oxcarbazepine
  5. Lamotrigine
  6. Gabapentin
  7. Topiramate
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2
Q

What is the only mood stabilizer shown to decrease suicidality?

A

Lithium

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3
Q

What are uncommon uses for mood stabilizers (4)?

A
  1. Potentiation of antidepressants in pts with major depression refractory to monotherapy
  2. Potentiation of antipsychotics in pts w/ schiz
  3. Enhancement of abstinence in tx of alcoholism
  4. Tx of aggression and impulsivity (dementia, intoxication, mental retardation, personality disorders, general medical onditions)
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4
Q

What is the drug of choice in acute mania and prophylaxis for both manic and depressive episodes in BP and SAD?

A

lithium

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5
Q

What are blood levels useful for? (4)

A

lithium, VPA, carbamazapine, clozapine

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6
Q

Where is lithium metabolized?

A

kidney

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7
Q

What is the onset of action for lithium?

A

5-7 days

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8
Q

Why are blood levels important for lithium?

A

blood levels correlate with clinical efficacy

- should be checked after 5 days, and every 2-3 days until therapeutic

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9
Q

What is the major drawback of lithium?

A

high incidence of side effects and very narrow therapeutic index

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10
Q

What is the therapeutic range of lithium?

A

0.7 - 1.2

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11
Q

What are factors that can affect lithium levels? (6)

A
  • NSAIDs (will lower)
  • aspirin
  • dehydration (will increase)
  • salt deprivation (will increase)
  • impaired renal function (will increase)
  • diuretics
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12
Q

What causes hypothyroidism, nephrogenic diabetes insipidus,, fine tremor, sedation, ataxia, thirst, metallic taste, polyuria, edema, weight gain, benign leukocytosis?

A

lithium

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13
Q

What can toxic levels of lithium cause?

A

altered mental status, coarse tremors, convulsions, and death

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14
Q

What is the mechanism of action of carbamazepine?

A

blocking sodium channel and inhibiting action potential

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15
Q

What are some side effects of carbamazepine? (5 in classes)

A
  1. GI = nausea, vomiting, diarrhea
  2. CNS = sedation, lightheadedness, tremor, cognitive blunting
  3. Electrolyte abnormalities (hyponatremia)
  4. Anticholinergic side effects
  5. Rash (can progress to Steven-Johnson syndrome)
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16
Q

What causes Ebstein’s anomaly in babies?

A

Lithium

17
Q

What can cause Steven-Johnson syndrome?

A

Carbamazepine, lamotrigine (Steven Johnson is a lame guy who likes carbs)

18
Q

What else can carbamazepine be used for?

A

trigeminal neuralgia

19
Q

What can carbamazepine cause when used during pregnancy?

A

neural tube defects

20
Q

What are 2 serious adverse effect of carbamazepine?

A
  1. Blood dyscrasias
    - aplastic anemia
    - agranulocytosis
    - thrombocytopenia
  2. Hepatotoxicity
21
Q

What can carbamazepine toxicity cause?

A
  • confusion
  • stupor
  • motor restlessness
  • ataxia
  • tremor
  • nystagmus
  • twitching
  • vomiting
22
Q

Which drugs go through the P450 pathway?

A
  1. carbamazepine
23
Q

What is the normal drug level of valproic acid?

A

50-150 micrograms/mL

24
Q

What is used to bipolar depression?

A

Lamotrigine

25
Q

Most common s/es of lamotrigine (4)

A
  1. Dizziness
  2. Sedation
  3. headaches
  4. ataxia
26
Q

What are 3 adjunctive mood stabilizers?

A
  1. Oxcarbazepine
  2. Gabapentin
  3. Topiramate
27
Q

Diff. b/w carbamazepine and oxcarbazepine?

A

Oxcarbazepine has much less potential for hematologic, dermatologic, and hepatotoxicity

28
Q

What is gabapentin also used for?

A

GAD and social anxiety

29
Q

What is a beneficial side effect of topiramate?

A

weight loss

30
Q

What are other side effects of topiramate? (3)

A
  • cognitive slowing (most limiting side effect)
  • hypochloremic non-anion gap metabolic acidosis
  • kidney stones

Psychopharm (5 decks)

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