Mood Stabilizers for Bipolar Depressive Disorders Lithium

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Lithium is the most frequently used agent for bipolar disease but it has a very narrow therapeutic index. Lithium is formulated as a chemical salt, of which lithium carbonate is the most commonly prescribed (citrate, sulfate, orotate are alternatives). Dosing is BID or TID. Therapeutic trough levels are typically 1.0-1.5 mEq/l for acute mania and 0.6-1.2 mEq/l for chronic maintenance. Regular serum lithium level testing is necessary. Important to monitor renal and thyroid function. Can be used in the treatment of cluster headache syndromes.

Valproic acid (Depakote®®): GABA transaminase inhibitor as well as inhibitor of voltage-gated sodium channels and T-type calcium channels. Valproate is a known folate antagonist, which can cause neural tube defects, so avoid in pregnancy if possible.

Carbamazepine (Tegretol®®): previously discussed under "Anticonvulsants." Lamotrigine (Lamictal®®): previously discussed under "Anticonvulsants."

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Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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