Mood Stabilizers Flashcards
What is the most well-known mood stabilizer?
Lithium
What class of medications are used to prevent mood episodes in patients with bipolar disorder?
Mood stabilizers
Depakote
Valproate
Lamictal
Lamotrigine
Tegretol
Carbamazepine
Trileptal
Oxcarbazepine
With regard to mechanism of action, how is lithium believed to impact serotonin and serotonin receptors?
It can decrease the presynaptic serotonin reuptake
It can increase postsynaptic serotonin receptor sensitivity
With regard to mechanism of action, what type of signaling does lithium affect?
G-protein signaling
With regard to mechanism of action, how does lithium impact inositol?
It can decrease inositol production by inhibiting inositol monophosphatase
What other enzyme does lithium inhibit?
Glycogen synthase kinase 3b
True or false: lithium has also been shown to affect adenylyl cyclase
True
What are Valproate, Lamotrigine, carbamazepine, and Oxcarbazepine collectively known as?
Generally speaking, how did they influence neurons?
They are known as anticonvulsants
They primarily reduce the excitatory potential of neurons
What are the two FDA approved indications for mood stabilizers?
Bipolar disorder and major depressive disorder (adjunctive therapy)
What is the non-FDA approved use of mood stabilizers?
Anxiety
Which three cardiovascular irregularities are seen as an adverse reaction of lithium use?
AV block, bradycardia, & flattened or inverted T-waves
What 3 other adverse drug reactions are seen with lithium use?
Hypothyroidism
Hyperparathyroidism
Nephrotoxicity
What are the four main adverse drug reactions seen with anticonvulsant use?
Hyponatremia – SIADH like syndrome
Thrombocytopenia
Hyperammonemia
Rash (Stevens-Johnson syndrome)
Lithium should be used cautiously with which two medications?
What is the effect of the interaction and the recommendation if they are used together?
ACE inhibitors & angiotensin receptor blockers (ARBs)
These two medications increase the levels of lithium in the blood
When used together, monitor lithium levels and adjust dose as needed