Mood stabilizing drugs – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Mood stabilizing drugs
Mood stabilizing drugs:
Mood stabilizers are drugs used in bipolar disorder to stabilize the fluctuating extreme mood states.
Uses of mood stabilizing drugs:
1. Prevent or to minimize future episodes of mania or depression or to some extent.
2. Reduce the severity of these mood disorders.
3. Prevents or minimizes the highs and lows that characterize bipolar illness.
[Ref: S Nambi/24/184]
Important mood stabilizers:
The following are the important mood stabilizers:
1. Lithium.
2. Anticonvulsants
- Valproate
- Carbamazepine
- Oxcarbazepine
- Lamotrigine
- Topiramate
[Ref: S Nambi/2/184]
Indications of lithium:
1. Prevention and treatment of mania, hypomania, and bipolar disorders.
2. In the treatment of recurrent depression.
3. Severe depressive patients with suicidal tendencies.
[Ref: S Nambi/2/185]
Mechanism of action of lithium:
Neuro-biologic effects:
- Normalizes the reuptake of certain neurotransmitters For example, Serotonin, norepinephrine, acetylcholine and dopamines
- It reduces the release of norepinephrine through competition with calciums
- Acts directly on G-proteins and enzymes subsystems.
Side effects of lithium
Side effects of lithium:
1. Mild nausea
2. Diarrhoea
3. Anorexia
4. Tremor
5. Polydypsia
6. Polyuria
7. Metallic taste in the mouth
8. Fatigue/lethargy
9. Weight gain
10. Lack of coordination
11. Nephrogenic diabetes insipidus,
12. Interstitial nephritis,
13. Reversible hypothyroidism.
14. Renal failure, coma and death.
[Ref: S Nambl/24/185+ KP Neeraja/1/Vol-1/281]
Lithium toxicity:
Lithium toxicity can occur when serum lithium level goes beyond 2 mmol/L
Causes of lithium toxicity:
- Inadequate fluid intake,
- Diarrhea,
- Dehydration,
- Increased sweating in summer
Clinical feature:
- Tremor,
- Ataxia,
- Dysarthria,
- Nystagmus,
- Renal impairment, and
- Convulsion.
Management:
Periodic monitoring of serum lithium level, monitoring BUN and serum creatinine stop lithium when symptoms of toxicity occur, increase the sodium and fluid intake, dialysis, if necessary
Nursing care:
- Estimation of Lithium in blood has to be recorded periodically
- Along with. meals, drug has to be taken to minimize side effects
- Ask the client not to drive until sedation, blurred vision, etc. subsides,
[Ref: S Nambi/2/185+ KP Neeraja/1″/Vol-1/281]
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