PDA III Exam III - Bipolar - HM

what is bipolar disorder

periods of mania and periods of depression

what is mania

an exaggerated feeling of elation

what are some symptoms of mania

feeling of faultlessness, bursting with energy, no need for sleep, excessively talkative, racing through thoughts and ideas, unlimited confidence, impulsive decision making

what is the common onset of bipolar disorder

in the 20's (most people but not everyone)

what is bipolar I disorder

periods of major depression, periods of mania, or mixed periods (depression with 3 mania symptoms for a week)

what is bipolar II disorder

periods of hypomania and major depression

what is cyclothymic disorder

periods of hypomania and depression that doesn't qualify as major depression

what is the onset of action of lithium

7-10 days

what is the MOA of lithium

inhibits phosphatases involved in recycling IP3 back to PIP2 (but no idea how it connects to mood)

what are the side effects of lithium

nausea, vomiting, tremors, hypothyroidism, polyuria, and polydipsia

which side effects occur due to plasma concentrations of lithium being too high

GI side effects, tremors, and hypothyroidism

which side effects are due to action at the kidneys, not blood levels

polyuria and polydipsia

what does lithium do to the kidneys

prevents ADH (vasopressin: helps body concentrate the urine) from acting at the collecting duct

how do thiazide diuretics affect lithium

thiazide diuretics work to reabsorb sodium back into the body at the proximal tube, and the transporters cannot tell the difference between sodium and lithium, so lithium gets reabsorbed back into the body as well

what is the effective plasma level range of lithium

0.6-1.3 mEq/L

at what plasma level does lithium become toxic

> 1.5

what are some other drug classes that can be used for bipolar disorder

anticonvulsants and atypical antipsychotics

what are the anticonvulsants that can be used for bipolar disorder

carbamazepine (mania/mixed) valproic acid (mania/mixed), and lamotrigine (maintenance)

what are the atypical antipsychotics that can be used for bipolar disorder

aripiprazole (mania/mixed and maintenance), quetiapine (mania/mixed, depression and maintenance), quetiapine-fluoxetine (depression), risperidone (mania/mixed and maintenance), olanzapine (mania/mixed and maintenance), lurasidone (depression), and cariprazine (mania/mixed and depression)

can antidepressants be used for bipolar disorder

antidepressants are not better than mood stabilizers for preventing depression and can trigger a manic episode