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Bipolar

QuestionAnswer
Bipolar I manic and major depressive episodes
Bipolar II hypomanic and major depressive episodes
Cyclothymia numerous of hypomanic and depressed episodes not classified as major; occur > 2 years
Lithium ADR tremor, polydipsia, polyuria, nausea, diarrhea, weight gain, hypothyroidism, mental dulling
lithium levels acute 0.6-1.2; maintenance 0.8-1.0
Lithium CI renal disease, severe CV disease, leukemia history, first trimester pregnancy, hypersensitivity
Lithium monitoring thyroid, SCr/BUN, electrolytes, ECG, urinalysis, pregnancy, lithium level
mild lith tox 1.5-2; GI upset, muscle weakness, fatigue, fine hand tremor, difficulty concentrating/memory
moderate lith tox 2-2.5; ataxia, lethargy, nystagmus, worsening of confusion, severe GI upset, coarse tremors, increase in deep tendon reflexes
severe lith tox >3; severely impaired consciosness, coma, seizures, resp complication, death
treatment of bipolar lithium and VPA first line for acute/prophy; CBZ second line for acute/prophy; lamotrigine approved for bipolar I; atypical antipsychotics approved; Olanzapine/fluoxetine (symbyax); gabapentin for adjunctive; debatable about oxcarbazepine topiramate & CCB
Created by: cytoskeletor
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