Bipolar Disorder Treatment and Lithium Management

These flashcards cover key concepts related to the treatment of bipolar disorder and the management of lithium therapy, including medications, monitoring, side effects, and interactions.

What are the primary treatment options for a patient in a manic phase of bipolar disorder?

Antipsychotic drugs such as haloperidol, olanzapine, quetiapine, or risperidone, and stopping any antidepressants.

What else do we consider if pt is experiencing hypomania/ mania?

If pt taking lithium, check its in range

What is bipolar disorder?

Extreme fluctuation between manic and depressive episodes

What should be monitored before initiating lithium treatment?

FBC (Full Blood Count) and ECG, particularly if there's a risk of heart disease.

What is the preferred long-term management approach for bipolar disorder?

1. Lithium, 2. Antipsychotic (switch if ineffective), 3. Valproate with antipsychotic.

What are some key side effects of lithium?

Thyroid disorder, nephrotoxicity, benign intracranial hypertension, tremors, and teratogenic effects, rhabdomyolysis

What medications should we use in depression phase of bipolar disorder

Fluoxetine + olanzapine, quetiapine, lamotrigine, olanzapine

What is the therapeutic range for lithium monitoring?

0.6 to 0.8 mmol/L.

How often should lithium levels be monitored for the first year of treatment?

Measure 12 hours after dose every week until stable, followed by every 3 months for the first year, and then every 6 months thereafter.

What is a significant interaction risk associated with lithium?

Increased risk of toxicity when combined with NSAIDs, diuretics, ACE inhibitors, ARBs, and other drugs that are renally cleared.

What symptoms indicate a potential overdose of lithium?

Sickness, tremors, benign intracranial hypertension, diarrhoea, vomiting, blurred vision, drowsiness, and confusion.

What should be maintained while on lithium treatment?

Adequate sodium and fluid intake.

Which medications can cause serotonin syndrome when taken with lithium?

SSRIs, TCAs, and some antidepressants.

What parameters should be measured before initiation and every 6 months

BMI, RFT, TFT

How should lithium be prescribed

By brand only