Medications for Bipolar Disorder

Lithium (Mood Stabilizer)

• Function: Treats bipolar disorder by influencing neurotransmitter reuptake.

Common Side Effects

• GI upset
• Fine hand tremors
• Polyuria (due to nephrogenic diabetes insipidus)
• Weight gain
• Kidney toxicity
• Electrolyte imbalances
• Fatigue
• Hypothyroidism
• Leukocytosis

Mnemonic: "LITH"

• L: Leukocytosis
• I: Insipidus (diabetes insipidus, polyuria)
• T: Tremors (fine hand tremors, coarse tremors = toxicity)
• H: Hypothyroidism

Black Box Warning

• Risk of lithium toxicity
• Monitor plasma levels closely (should stay under 1.5 mEq/L)

Signs of Toxicity

• Coarse tremors
• Confusion
• Hypotension
• Seizures
• Tinnitus

Patient Teaching

• Maintain adequate sodium and fluid intake
• Avoid diuretics (can lead to sodium and water loss)
• Avoid anticholinergics
• Avoid NSAIDs (risk of kidney toxicity)
• Contraindicated in patients with renal disease

Anticonvulsants for Bipolar Disorder

Common Medications

1. Carbamazepine
2. Valproic Acid
3. Lamotrigine

Carbamazepine

Side Effects

• Blood dyscrasias (anemia, thrombocytopenia, leukopenia)
• Vision issues
• Hypo-osmolarity (due to SIADH causing water retention)
• Serious skin rashes

Black Box Warning

• Anemia
• Serious skin rashes
• Leukopenia

Monitoring

• CBC levels (due to blood dyscrasias)
• Signs of infection (due to leukopenia)

Valproic Acid

Side Effects

• Hepatotoxicity
• Pancreatitis
• GI upset
• Thrombocytopenia

Black Box Warning

• Hepatotoxicity
• Pancreatitis
• Neural tube defects in developing fetuses

Monitoring

• Liver function (AST, ALT, bilirubin levels)

Lamotrigine

Side Effects

• Dizziness
• GI upset
• Photosensitivity
• Rash

Black Box Warning

• Serious skin rashes

Next Topic

• Medications used to treat psychotic disorders, including schizophrenia.