Mood Stabilizers

Question 1

Lithium: mechanism of actino, halflife, side effects, testing necessary?

Answer 1

Inhibits adenylate cyclase enzyme; 24h; Nausea, tremor (propanolol may help), hypothyroidism, cardiac dysrhythmias, diarrhea, benign WBC increase, Diabetes insipidus, weight gain, acne, at toxic levels alteration in concsiousness, seizures, coma, and death; serum levels must be checked every 5-7 after dose change and 6-12 months when stable together with Renal function tests (CrCl, BUN, Cr), thyroid function tests, hCG in women, ECG.

Question 2

Valproic acid: mechanism of actino, halflife, side effects, testing necessary?

Answer 2

Opens chloride channels (unknown completely); 8h; Thrombocytopenia, pancreatitis, weight gain, hair loss, GI distress, cognitive dulling, neural tube defects in pregnancy; CBC, LFTs, pancreatic enzyme levels, hCG in women.

Question 3

Cabamazepine: mechanism of actino, halflife, side effects, testing necessary?

Answer 3

Inhibits kindling, inhibits repetitive firing of action potentials by inactivating sodium channels, may also induce cyp450; 18-55h; Nausea, vomiting, slurred speech, dizziness, drowsiness, low WBC, high LFTs, cognitive slowing, craniofacial defects in newborn; test CBC, LFTs, pancreatic enzyme levels, serum hCG in childbearing women.

Question 4

Lamotrigine: class, halflife, side effects, testing necessary?

Answer 4

mood stabilizer/antiseizure, 15h; Leukopenia, rash (esp if dose increased quickly), hepatic failure, nausea, vomiting, diarrhea, somnolence, dizziness, may have antidepressant effect acutely; CBC with PLT every 6-12m.

Question 5

Gabapentin: class, halflife; side effects, notable benefit?

Answer 5

Analgesic/antiepileptic/mood stabilizer; 5-9h; somnolence, dizziness, ataxia, fatigue, leukopenia, weight gain, fatal rash; no drug interactions