RNSG 2213 (M.H.) - Exam 2, Modlule 4: Bipolar Meds|Pharmacologic Management of Bipolar Disorder: Lithium, Anticonvulsants, Antipsychotics, Benzodiazepines, Acute Mania, Bipolar Depression, Mood Stabilizers, Rapid Cycling, Mixed States, Lurasidone, Quetiap

RNSG 2213 (M.H.) - Exam 2, Modlule 4: Bipolar Meds|Pharmacologic Management of Bipolar Disorder: Lithium, Anticonvulsants, Antipsychotics, Benzodiazepines, Acute Mania, Bipolar Depression, Mood Stabilizers, Rapid Cycling, Mixed States, Lurasidone, Quetiapine, Lamotrigine, Therapeutic Drug Monitoring, Serum Levels, Narrow Therapeutic Index, Toxicity, Electrolyte Interactions, Sodium Balance, Renal Function, Hypothyroidism, Side Effects, EPS, Metabolic Syndrome, Drug Adherence, Psychoeducation, ECT, Catatonia, Psychomotor Agitation, Suicide Risk, Pregnancy Considerations, Patient Safety, Non-Adherence, Multidisciplinary Care Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 4 Major Classes of Medications for Bipolar Disorder 1. Lithium 2. Anticonvulsants 3. Antipsychotics 4. Benzodiazepines- acute mania, psychomotor agitation, anxiety (not a core treatment but short term basis only) Why are Antidepressants for Bipolar Depression not on list? ¢Antidepressant therapy for the most part is not recommended in persons with bipolar disorder because of risk of switching to mania. ¢Antidepressants if used, used usually with a mood stabilizer, risk/benefit ratio considered. Overview points: medications Individuals often require multiple meds. The meds we discuss may be used alone or in combinations. No single drug or combination is always effective Treatment goals for bipolar disorder which meds are instrumental in achieving: 1.Get acute mania under control 2.Prevent relapse 3.Return to prior level of functioning 4 Mood stabilizers for Desert Island per Dr. Aiken 1. Lithium – all 3 phases (mania, depression, maintenance) 2. quetiapine (Seroquel) – all 3 phases + rapid cycling + mixed state 3. lurasidone (Latuda) – for bipolar depression 4. lamotrigine (Lamictal) – for bipolar depression, mood stabalizer Chris Aiken, MD Mood Disorders Section Editor for Psychiatric Times Lithium ¢Used for mania and depression and long term maintenance to prevent future episodes ¢Reputation for decreasing suicide (from 20% down to risk 10 %) ¢Narrow therapeutic index = .6-1.2 ¢Blood concentration must be carefully monitored ¢Until lithium reaches therapeutic levels (7-14 days) can be on antipsychotic, antianxiety meds. ¢300 mgs to 600 mgs 2-3x a day ¢“to avoid serious toxicity levels should not exceed 1.5mEq/l ¢To treat acute mania: .6 – 1.2 mEq/L ¢Maintenance levels: .8 mEq/L ¢Blood levels usually drawn before first dose in am (8-12 hrs after last dose) (take it at it's trough, lowest, level in the morning before given)