Mood Stabilizers

Question 1

Lithium: mech

Answer 1

Not established; possibly related to inhibition of phophoinositol cascade

Question 2

Lithium: uses

Answer 2

Mood stabilizer for bipolar disorder; blocks relapse and acute manic events. Also SIADH

Question 3

Lithium: tox

Answer 3

Tremor, sedation, edema, heart block, hypothyroidism, polyuria (ADH antagonist causing nephrogenic diabetes insipidus), teratogenesis. Fetal cardiac defects include Ebstein anomaly and malformation of the great vessels. Narrow therapeutic window requires close monitoring of serum levels. Almost exclusively excreted by kidneys; most is reabsorbed at proximal convoluted tubules following Na+ reabsorption.
Thiazide use is implicated in lithium toxicity in bipolar pts.

Question 4

LMNOP side effects:

Answer 4

Lithium side effects: 
Movement (tremor) 
Nephrogenic diabetes insipidus
HypOthyroidism
Pregnancy problems
Pts in early stages of lithium toxicity may appear drunk. Diff to distinguish between lithium toxicity and alcohol toxicity.

Question 5

Buspirone: mech

Answer 5

Stimulates 5-HT1A receptors

Question 6

Buspirone: uses

Answer 6

Generalized anxiety disorder. Does not cause sedation, addiction, or tolerance. Takes 1-2 weeks to take effect. Does not interact with alcohol (vs. barbiturates, benzodiazepines). More effective in treating cognitive symptoms (vs somatic)
I’m always anxious if the BUS will be ON time, so I take BUSpirONe.