Psych FINAL Flashcards
What is the first-line treatment for all phases of Bipolar Disorder (BPD)?
Lithium
What are the most common mood stabilizers used for BPD?
Lithium, Valproate (VPA), Lamotrigine, Carbamazepine, Oxcarbazepine
Which mood stabilizer is the most effective for preventing manic relapse?
Lithium
Which medication is preferred for rapid cycling or substance use comorbidity in BPD?
Valproate (VPA)
What is the primary use of Lamotrigine in BPD?
Maintenance therapy for bipolar depression
Which medication is a second-line option after Lithium and Valproate?
Carbamazepine
What is the monitoring schedule for Lithium therapy?
Check blood levels after 5 days, then weekly until stable, then every 3 months
What organ function must be monitored when taking Lithium?
Kidney (serum creatinine, UA) and Thyroid (TFTs every 6 months)
Why should Lithium be avoided in the first trimester of pregnancy?
Risk of cardiac malformations
What are common side effects of Lithium?
Nausea, diarrhea, tremor, polyuria, polydipsia, hypothyroidism
Which medication is effective for acute mania but not for maintenance therapy?
Valproate (VPA)
Which medication is the preferred treatment for bipolar depression?
Lamotrigine
Why must Lamotrigine be titrated slowly?
To reduce the risk of serious rash (Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis)
Which mood stabilizer is known to cause weight gain, sedation, and increased liver enzymes?
Valproate (VPA)
What should be monitored when prescribing Valproate?
CBC, liver function tests (LFTs), ammonia levels
Which mood stabilizers require serum Na+ monitoring?
Lithium, Carbamazepine, Oxcarbazepine
What is the risk of using Carbamazepine in pregnancy?
Neural tube defects and developmental delays
Which second-generation antipsychotics (SGAs) are used for acute mania?
Olanzapine, Risperidone, Aripiprazole, Ziprasidone, Quetiapine
Which SGA is most effective for acute mania stabilization?
Olanzapine
What is the recommended duration of an adequate trial for an SGA in acute mania?
3-4 weeks at the maximum tolerated dose
Why should antidepressants be used cautiously in BPD?
They may induce mania or rapid cycling
Which antidepressant is least likely to trigger mania in BPD?
Bupropion
What is the combination therapy rule when using antidepressants in BPD?
Never use an antidepressant as monotherapy; combine with a mood stabilizer like Lithium, Quetiapine, or Lamotrigine
What lifestyle modifications can help manage BPD?
Regular sleep, diet, exercise, therapy, medication adherence