Mood Stabilizers

Lithium and Anticonvulsants

Bipolar Disorder (BPD)

Mood stabilizers are used to treat ________.

lithium and anticonvulsants (valproic acid and carbamazepine )

The two types of mood stabilizers are ________.

reducing the frequency and severity of BPD episodes

Lithium and anticonvulsants work by ________.

0.5-1.2

therapeutic serum lithium levels = ________.

1.5 or more

toxic serum lithium levels = ________.

Lithium may reduce symptoms within 5-7, but it may take 2-3 weeks to reach full effect.

Lithium may reduce symptoms within ________, but it may take ________ to reach full effect.

“LITH”

• Leukocytosis (elevated WBC count)

• nephrogenic diabetes Insipidus

• Tremors / Teratogen

• Hypothyroidism

What are the adverse effects of lithium?

Early = nausea, vomiting, diarrhea

Late = restlessness, agitation, tremors, slurred speech, seizures, arrhythmias

What are the signs of lithium toxicity?

• too high dosage of lithium

• hyponatremia from diuretics or decreased sodium in diet

• hypovolemia due to diarrhea, vomiting, or sweating

• decreased elimination due to kidney issues

What factors may result in lithium toxicity?

• Regular monitoring of electrolytes, kidney function, and thyroid function

• Regular monitoring of serum lithium level

• Avoid salt restricted diet

• Adequate fluid intake

• Limit caffeine

• Use reliable contraception due to teratogenic nature of the drug

• Take consistently as prescribed — do not stop if feeling better

What should education for a client taking lithium include?

BPD and seizures

• note: carbamazepine may also be used for trigeminal neuralgia

Valproic Acid and Carbamazepine are anticonvulsants used to treat ________.

• thrombocytopenia (low PLTs)

• pancreatitis

• liver failure

Divalproex Sodium (valproic acid) has few adverse side effects, including ________.

• hypersensitivity

• bone marrow suppression

• hyponatremia from SIADH

What are the adverse effects of carbamazepine?

teratogenic

Like lithium, carbamazepine and divalproex sodium (valproic acid) are ________, meaning they should not be taken during pregnancy and reliable contraception should be used.