NURS752: Mood Stabalizers
Study online at https://quizlet.com/_fh4in5
1. What is an elevated mood 3 symptoms (elation) or 4 symptoms (irritability):De-
creased need for sleep Distractibility Excessive involve-
ment in high risk pleasurable activity Flight of ideas
Grandiosity Increase in energy, goal-directed activity
or psychomotor agitation Pressured speech
2. Bipolar spectrum There is a huge variation in the presentation of patients
with bipolar disorder. Historically, bipolar disorder has
been categorized as I, II, or not otherwise specified
(NOS). think of these patients as belonging to a bipolar
spectrum and to identify subcategories of presenta-
tions
3. Bipolar Disorder-Treatment Acute therapy: manic episode Lithium Valproic acid If
needed: antipsychotic or benzo Acute therapy: depres-
sive phase Mood stabilizer alone or with an antide-
pressant Long-term prevention One or more mood
stabilizers and other drugs which are needed acutely
4. Lithium MOA: Not clear Lithium is effective both for the man-
ic and depressive components. Today lithium is pre-
ferred for patient with classic (euphoric) mania Onset
of effect: Antimanic effects begin 5-7 days after onset
of treatment. Takes 2-3 weeks to see full lithium effects
Renal excretion of lithium is effected by blood levels
of sodium When Na levels are inadequate it retains
Lithium in an attempt to compensate. In the presence
of hyponatremia, lithium toxicity can occur
5. Lithium Gold standard A 1. The exact mechanism of action for lithium is un-
known, but it appears to be neuroprotective. 2. Lithium
continues to be the gold standard for treating type I
, NURS752: Mood Stabalizers
Study online at https://quizlet.com/_fh4in5
bipolar disorder. It is effective for the manic and de-
pressive components. Although it is not a particularly
good antidepressant as monotherapy in unipolar de-
pression, it is effective in patients with bipolar disorder.
Lithium also has anti-suicidal effects when used to
treat bipolar disorder.
6. Lithium Gold Standard B 3. Antimanic effects can occur in 1-2 weeks. Most clin-
icians use antipsychotics or benzodiazepines as ad-
junctive therapy during this period to cover the ag-
itation and other symptoms. Antidepressant effects
may take 6-8 weeks. 4. Pharmacokinetics: Its half-life
is 20-24 hours. It is excreted 95% unchanged by
glomerular filtration, and anything that alters the
glomerular filtration rate affects its clearance. Pharma-
cokinetic methods are available for early prediction of
doses, but waiting 5-6 days for steady state seems to
work just as well.
7. Lithium Gold standard C 5. Initial dosing is 600-900 mg/day in divided doses
and then titrated according to response and tolerabili-
ty. Maintenance doses are based on serum concentra-
tions, symptom relief, and the occurrence of adverse
effects. 6. A pre-lithium workup includes a complete
blood cell count, electrolytes, renal function, thyroid
function tests, urinalysis, ECG, and pregnancy test for
women of childbearing age.
8. Lithium gold standard D 7. Pregnancy: Lithium is teratogenic, particularly in the
first trimester. Women of childbearing age should be
counseled on its potential effects. Risks of discontin-
uing lithium therapy must be weighed against effects
Study online at https://quizlet.com/_fh4in5
1. What is an elevated mood 3 symptoms (elation) or 4 symptoms (irritability):De-
creased need for sleep Distractibility Excessive involve-
ment in high risk pleasurable activity Flight of ideas
Grandiosity Increase in energy, goal-directed activity
or psychomotor agitation Pressured speech
2. Bipolar spectrum There is a huge variation in the presentation of patients
with bipolar disorder. Historically, bipolar disorder has
been categorized as I, II, or not otherwise specified
(NOS). think of these patients as belonging to a bipolar
spectrum and to identify subcategories of presenta-
tions
3. Bipolar Disorder-Treatment Acute therapy: manic episode Lithium Valproic acid If
needed: antipsychotic or benzo Acute therapy: depres-
sive phase Mood stabilizer alone or with an antide-
pressant Long-term prevention One or more mood
stabilizers and other drugs which are needed acutely
4. Lithium MOA: Not clear Lithium is effective both for the man-
ic and depressive components. Today lithium is pre-
ferred for patient with classic (euphoric) mania Onset
of effect: Antimanic effects begin 5-7 days after onset
of treatment. Takes 2-3 weeks to see full lithium effects
Renal excretion of lithium is effected by blood levels
of sodium When Na levels are inadequate it retains
Lithium in an attempt to compensate. In the presence
of hyponatremia, lithium toxicity can occur
5. Lithium Gold standard A 1. The exact mechanism of action for lithium is un-
known, but it appears to be neuroprotective. 2. Lithium
continues to be the gold standard for treating type I
, NURS752: Mood Stabalizers
Study online at https://quizlet.com/_fh4in5
bipolar disorder. It is effective for the manic and de-
pressive components. Although it is not a particularly
good antidepressant as monotherapy in unipolar de-
pression, it is effective in patients with bipolar disorder.
Lithium also has anti-suicidal effects when used to
treat bipolar disorder.
6. Lithium Gold Standard B 3. Antimanic effects can occur in 1-2 weeks. Most clin-
icians use antipsychotics or benzodiazepines as ad-
junctive therapy during this period to cover the ag-
itation and other symptoms. Antidepressant effects
may take 6-8 weeks. 4. Pharmacokinetics: Its half-life
is 20-24 hours. It is excreted 95% unchanged by
glomerular filtration, and anything that alters the
glomerular filtration rate affects its clearance. Pharma-
cokinetic methods are available for early prediction of
doses, but waiting 5-6 days for steady state seems to
work just as well.
7. Lithium Gold standard C 5. Initial dosing is 600-900 mg/day in divided doses
and then titrated according to response and tolerabili-
ty. Maintenance doses are based on serum concentra-
tions, symptom relief, and the occurrence of adverse
effects. 6. A pre-lithium workup includes a complete
blood cell count, electrolytes, renal function, thyroid
function tests, urinalysis, ECG, and pregnancy test for
women of childbearing age.
8. Lithium gold standard D 7. Pregnancy: Lithium is teratogenic, particularly in the
first trimester. Women of childbearing age should be
counseled on its potential effects. Risks of discontin-
uing lithium therapy must be weighed against effects
