Mood Stabilizers

Question 1

multi-drug cocktails

Answer 1

• trying & failing to get control of illness- keep adding- chasing side effects- psychstim to combat antipsych demotivation etc.
• unpredictable drug interactions= destabilization.
• emerging dependence, withdrawal, tolerance- prob stopping safely- give child/teen still dev brains.

Question 2

Concept of MS

Answer 2

• vague imprecise term.
• more associated with drug marketing than science.
• originally anti-convulsants used prevent epileptic fits & seizures- now stabilize mood.

Robert Post- drew analogy b/w epileptic fits & seizures- both episodic.
–thought epilepsy & BD got worse with age (BD actually doesn’t).

IDEA- anticonvulsants stabilize brain to prevent fits- may also stabilize mood -tenuous link.

• -epilepsy fits lasts secs/mins & reoccur on timescale days/weeks.
• -BUT–
• -BD eps last months & timescale several years.
• non were effective for Mania/Depress
• -only few had psychiatric value.

Question 3

Carbamazepine

Answer 3

Japan 1960s (found/used before Post’s theory)

• kinda effective controlling Mania not Depress.
• -reduces irritability/agg- kind of tranq.
• lots of side effects-
• impaired coordination, turns off white blood cells- vulnerable to infection- needs to be monitored.

Question 4

Sodium Valproate

Answer 4

• valpromide, valproic acid, epilim (for children)- used in France 1960s.
• took off in 1990s when new patented versions.
• mainly used prevent Mania- not used acute cases,
• side effects-
• sleepiness, weight gain.

Question 5

Lamotrigine

Answer 5

has anti-d properties

• somewhat stimulating roughly psycho-stimulant.
• side effects-
• Steven Johnson’s disease- rare skin condition can be fatal. -increase dose slowly + monitor.

Question 6

Gabapentin

Answer 6

• falsely marketed as mood stabilizer.

- like Bz but with more side effects.

Question 7

Antipsychotic

Answer 7

effective treatment of acute Mania–> cus of this relabeled as Mood Stabilizer & assumed it would prevent mania.
-atypical antipsychotic very sedating.
(6 billion dollars a year)