Medications for Bipolar Disorder

Jul 23, 2024

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.