Psych Medications: Mood Stabilizers

Anti-manic and Mood Stabilizing drugs (Lithium, Depakote, Lamictal, Tegretol, Trileptal)

  • LITHIUM is the drug of choice for controlling manic episodes
  • lithium has a narrow therapeutic index (~0.6-1.2), familiarize yourself with the different LEVELS OF TOXICITY
  • normal SE of lithium include fine tremors, mild thirst, mild nausea and general discomfort – if they persist, may indicate toxicity
  • remember that DEHYDRATION (excess nausea, diarrhea, sweating, diuretics) may cause lithium TOXICITY
  • SE of toxicity include coarse tremors, persistent GI upset, confusion, muscle irritabbility, ECG changes, incoordination
  • lithium level of > 2.5 may = DEATH
  • Tegretol may cause agranulocytosis – monitor WBCs
  • Lamictal may cause Steven-Johnson’s – monitor platelets
  • Depakote may cause hepatotoxicity and thrombocytopenia – monitor LFTs and platelets
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