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Questions and Answers
Which aspect is NOT considered an ideal function of a mood stabilizer according to the content?
Which aspect is NOT considered an ideal function of a mood stabilizer according to the content?
- To exacerbate depressive episodes (correct)
- To act as a prophylactic treatment
- To be effective in acute manic phases
- Show some efficacy for mood, psychotic, and cognitive symptoms.
What key quality should mood stabilizers demonstrate according to Keck?
What key quality should mood stabilizers demonstrate according to Keck?
- They should cause sedation during manic episodes
- They should show some efficacy in preventing mood swings (correct)
- They should show efficacy in treating multiple stages of Bipolar illness simultaneously
- They should be able to calm people without any side effects
What is a characteristic of sedating drugs in regard to mania?
What is a characteristic of sedating drugs in regard to mania?
- They provide no relief from mood symptoms
- They can only treat depressive episodes
- They induce hyperactivity in manic patients
- They produce a change in people suffering from mania (correct)
What was the initial purpose of injecting uric acid into guinea pigs?
What was the initial purpose of injecting uric acid into guinea pigs?
What was a significant problem encountered when injecting uric acid?
What was a significant problem encountered when injecting uric acid?
Why did Cade decide to mix lithium with uric acid?
Why did Cade decide to mix lithium with uric acid?
What must be closely monitored when using lithium therapy?
What must be closely monitored when using lithium therapy?
What is the only FDA-approved use of lithium mentioned?
What is the only FDA-approved use of lithium mentioned?
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Study Notes
Depakote
- Depakote (valproic acid) was approved for the manic phase of Bipolar I Disorder in 1995
- Depakote was marketed as a prophylactic to prevent further mood swings but it was not approved for this function
- Abbott Laboratories' marketing of Depakote focused on the ambiguous concept of "mood stabilization."
Lithium Discovery
- Lithium was discovered in 1817
- John Cade, working with uric acid and guinea pigs in 1949, found that lithium produced lethargy in guinea pigs
- Cade concluded that lithium may have calming effects on mood ("psychotic excitement")
- Cade's early research on lithium led to several patient deaths due to lithium toxicity
Lithium Treatment Efficacy
- Morgens Schou conducted randomized controlled trials in 1978 demonstrating the efficacy of lithium for Bipolar I Disorder
- Lithium remains the drug of first choice for Bipolar I Disorder
- Lithium is effective and enhances the effects of antidepressants but is often not preferred due to its side effects
Lithium Side Effects
- Lithium side effects are extensive and include:
- Cardiac issues
- Nausea
- Tremors
- Weight gain
- Thyroid issues
- Cognitive impairment
- Lithium is a drug that requires regular blood monitoring due to the narrow therapeutic window
Lithium Mechanisms of Action
- Lithium's mechanism of action is complex and not well understood.
- Lithium appears to modulate second-messenger systems, slowing down or speeding them up, which may decrease manic symptoms.
- Lithium is thought to affect signaling pathways responsible for the production of brain-derived neurotrophic factor (BDNF).
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