Mood Stabilizers | Psychotropic Drugs | Mental Health | Juhin J
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Mood stabilizers are medicines that treat and prevents highs(mania) and lows(depression). They also help to keep the mood from interfering with work, school or social life.
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Mood Stabilizers | Psychotropic Drugs | Mental Health | Juhin J
- 1. MOOD STABILIZERS JUHIN J 2ND YEAR MSC NURSING
- 2. OBJECTIVES At the end of this session, you’ll get clear understanding about; • What is meant by mood stabilizers • Action of mood stabilizers • Classifications of mood stabilizers • Lithium toxicity • Nurses responsibility
- 3. MOOD STABILIZERS Mood stabilizers are medicines that treat and prevents highs(mania) and lows(depression).They also help to keep the mood from interfering with work, shool or social life.
- 4. ACTION Mood stabilizers have multiple mechanism of action, which include modulation of aminobutyric acid and glutametric neurotransmission; alteration of voltage gated ion channels or intercellular signalling pathways. Mood stabilizers generally take 1-2 weeks for a good response to take effect, with some initial effects beginning within 48 hours.
- 5. CLASSIFICATION Anti manic Lithium Carbonate Anti Convulsants Clonazepam Carbamazepine Valporic acid Lamotrigine Gabapentine Topiramate
- 6. ANTI MANIC DRUG NAME USED FOR AVAILABLE FORMS MAXIMUM DOSE SIDE EFFECTS NURSES RESPONSIBILITY Lithium Carbonate • Mania • Bipolar affective disorder • Recurrent depression • Aggressive and self mutilating behaviors • Premenstrual tension • 300 mg plain tablets • 400 mg SR 1400 mg • Drowsiness • Seizure • Circulatory collapse • Polyuria • Proteinuria • Blurred vision • Teach the patient and relatives about the symptoms of minor toxicity. • Teach the patient not to operate machinery until lithium levels are stable. • Advice the patient to avoid alcohol. • Advice the patient that the drug effects may take 1-3 weeks. • Advice the patient not to stop medications abruptly. • Teach the patient and relatives to consult psychiatrist, if they found any side effects.
- 7. LITHIUM TOXICITY Lithium toxicity occurs when a person takes too much of lithium. Normal : 0.6-1.2 mEq/L Lithium Toxicity : 1.5 mEq/L or Higher Severe Lithium Toxicity : 2.0 mEq/L or Higher (Life threatening) Medical Emergency : 3.0 mEq/L or Higher SYMPTOMS: Drowsiness, Dizziness, Headache, Dry mouth, Nausea, Vomiting, Fine hand tremors, Arrhythmias, Pulse irregularities, Polyuria, Blurred vision, Muscle weakness, Sluggishness, Circulatory failure, Coma, Hypokalaemia, Death(Sometimes). CAUSES OF INCREASED LITHIUM: • Drugs that alter renal function (ACE inhibitors, NSAID’s,Thiazide diuretics) • General medical conditions(Decreased circulatory volume, viral infections, fever, gastroenteritis, diarrhoea, vomiting) • Decreased intake of water and salt. • Nephrogenic diabetes insipidus (side effect of chronic lithium treatment)
- 8. LITHIUM TOXICITY Cont.. MANAGEMENT: ➢ DETOXIFICATION • Administration of charcoal. • Gastric lavage- regular release preparations • Whole bowel irrigation – sustained release preparations ➢ ELIMINATION • Hemodialysis • Peritoneal dialysis should not replace hemodialysis. ➢ DISPOSITION • Hospitalized for monitoring • Moderate/severe symptoms- ICU • Lithium in serum – every 6 hours • Should not discharge – normal PREVENTION – Salt,Water(8-12 cups), Limit alcohol, Avoid Caffeine
- 9. ANTI CONVULSANTS DRUG NAME USED FOR AVAILABLE FORMS MAX DOSE SIDE EFFECTS Clonazepam • Epilepsy • Myoclonus • Status epilepticus • 0.25 mg • 1 mg • 2 mg 2 mg • Drowsiness • Confusion • Tremors • Headache • Anemia • Slurred speech Carbamazepine • Bipolar disorders (X L) • Manic depression illness (4+ epi/ yr) • Trigeminal neuralgia • Plain 100 mg • 200 mg • 400 mg CR 400 mg • Drowsiness • Suicidal thought • Hypertension • Alopecia • Headache • Anorexia Valporic acid • All forms of Epilepsy • 200 mg • 300 mg • 500 mg 2400 mg • Suicidal ideation • Ataxia • Headache • Insomnia • Stevens Johnson syndrome Lamotrigine • Generalized Tonic clonic seizures • Myoclonic seizures • 25 mg • 50 mg • 100 mg 700 mg • Suicidal ideation • Poor concentration • Tremor • Insomnia • Depression Gabapentine • Partial Seizures • Neuropathic pain • Bipolar disorder • 300 mg • 400 mg • 600 mg 3800 mg • Somnolence • Amnesia • Leukopenia • Stevens Johnson syndrome • Rash Topiramate • Partial Seizures • Bipolar disorder • 25 mg • 50 mg • 100 mg 400 mg • Dizziness • Fatigue • Memory loss • Tremors • Alopecia • Death-Epilepsy
- 10. NURSES RESPONSIBILITY • Advice the patient to take medications properly, not to discontinue abruptly. • Teach the patient and relatives to monitor the duration, type, intensity of seizure. • Advice the patient not to chew, crush or break ODT medications. • Advice the patient to avoid driving and operating machinery. • Advice the patient to avoid taking this drug along with grape fruit juice or on empty stomach. • Teach the patient and relatives that patient’s urine may turn pink to brown. • Advice the patient to consult prescriber if he/she has any side effects. • Advice the patient to avoid consuming alcohol.
- 11. ANY DOUBTS