Foundations
Neurotransmitters a/w mood disorders:
Norepinephrine & Serotonin
Helps/Hurts SI?
Reduces SI
Preferred for?
Rapid cycling d/o
Why not more common?
Tons of SE!
Tons D2D!
LamOTrgINe sounds like LOTION
Reminding me skin & horrible reactions
Endocrine issue a/w depression & mood instability
Hypothyroidism
Body parts this medication may adversely affect?
Range for lab?
50-100mcg/mL
BP depression, BP maintenance, Psychosis/Schizophrenia (adjunctive)
Therapeutic lab levels?
Not for this medication
1st line tmt for mood instability?
Mood stabilizers
Mild-Mod Toxicity?
1.5-2.0 & discuss sx
Therapeutic indications?
1- Acute Mania & 2- Acute BP Depression (helps agitation), 3- Schizoaffective
CYP3A4: ↑ ↓ ?
Decreases other meds (major inducer)
Bipolar & in depressed phase - try?
Lamotrigine or low-dose ziprasidone
Other meds besides main 4?
Oxycarbamazapine (Trileptal), Gabapentin (Neurontin). Topiramate ("Dopa"max)
Mod-Severe Toxicity?
2.0-2.5 & discuss sx (anorexia, NV!, etc...)
Rare SE?
Platelet dysfx, Agranulocytosis, Edema
SE?
Vision, GI, Vertigo, HEMATOLOGIC, Liver, Pancreas & Rash (SJS)
MOA?
Serotonergic
3 other Rx for Bipolar depression?
Quetiapine, Olanzapine-Fluoxetine & Lurasidone
Severe toxicity!?!?!
> 2.5: Convulsions, Oliguria, Renal Failure & DEATH!
What labs?
CBC, CMP & PLT (look for low WBC), Liver fx & Pregnancy
If used w/Depakote?
Decrease Tegretol
We appreciate your awesomeness! TY