LITHIUM – PSYCHIATRIC USAGE
| A | Valproate | |
| B |
Lamotrigine |
|
| C |
Lithium |
|
| D |
All of the above |
Treatment of choice in acute Bipolar disorder
| A |
Valproate |
|
| B |
Lamotrigine |
|
| C |
Lithium |
|
| D |
All of the above |
Ans:C-Lithium
The medication with the best overall evidence is lithium, which is an effective treatment for acute manic episodes, preventing relapses, and bipolar depression.
Lithium reduces the risk of suicide, self-harm, and death in people with bipolar disorder.
| A | Major depression | |
| B | Vascular headache | |
| C | Neutropenia | |
| D | Generalized anxiety disorder |
Generalized anxiety disorder
Which of the following represent the theraputic level of Lithium in serum?
| A |
0.8 – 1.2 meq/l |
|
| B |
0.6 – 1.2 meq/l |
|
| C |
>2 meq/l |
|
| D |
None |
Lithium is most commonly used in the treatment of bipolar depression. It has a low toxic : therapeutic ratio.
The therapeutic level of Lithium in serum is 0.8 – 1.2 mEq/L.
Lithium toxicity occur when serum lithium levels exceed 1.5 to 2 mEq/L.
Hence frequent bood tests are done to monitor the drug levels.
Lithium is fully metabilised by the kidney. Hence, dehydration could cause the drug levels to rise.
Ref: Current Medical Diagnosis and Treatment 2013, chapter 38.
The current agent of choice for treatment of the bipolar affective (manic-depressive) disorder is:
| A |
Chlorpromazine |
|
| B |
Haloperidol |
|
| C |
Diazepam |
|
| D |
Lithium carbonate |
Manic-depressive illness.Which is the the most appropriate pharmacotherapeutic agent?
| A |
Triazolam |
|
| B |
Tranylcypromine |
|
| C |
Methylphenidate |
|
| D |
Lithium carbonate |
A patient with bipolar disorder started lithium therapy. The maximum therapeutic level of lithium in serum is:
| A |
0.1 meq/L |
|
| B |
0.4 meq/L |
|
| C |
1.0 meq/L |
|
| D |
1.8 meq/L |
Concentrations considered to be effective and acceptably safe are between 0.6 and 1.5 mEq/L. The range of 1.0-1.5 mEq/L is favored for treatment of acutely manic or hypomanic patients. Serum concentrations of Li+ have been found to follow a clear dose-effect relationship between 0.4 and 1.0 mEq/L, but with a corresponding dose-dependent rise in polyuria and tremor as indices of adverse effects.
| A |
Unipolar MDP prophylaxis |
|
| B |
Bipolar MDP prophylaxis |
|
| C |
Schizophrenia |
|
| D |
Acute mania |
Ans:B-Bipolar MDP prophylaxis
Lithium: Indications:
- Established indications:
- Treatment of acute mania
- Prophylaxis of bipolar mood disorder.
- Possible clinical indications:
- Treatment of the schizo-affective disorder
- Prophylaxis of unipolar mood ilisorder
- Treatment of cyclothymia
- Treatment if acute depression(as an adjuvant for refractory depression)
- Treatment of chronic alcoholism(in presence of significant depressive symptoms) 6 psychoactive use disorders(e.g cocaine dependence)
- Treatment of impulsive aggression.
- Treatment of Keine-Levin syndrome
Which is the drug of choice for maintenance therapy in uncomplicated bipolar disorder ?
| A | Sodium valproate | |
| B |
Carbamazepine |
|
| C |
Lithium |
|
| D |
Lamotrigine |
Ans. is ‘c’ i.e., Lithium
Drug of choice for prophylaxis of mania is ‑
| A |
Lithium |
|
| B |
Haloperidol |
|
| C |
Clozapine |
|
| D |
Carbamazepine |
Ans. is ‘a’ i.e., Lithium
A patient of maniac depressive psychosis is on lithium, clozapine and fluphenazine. During the course of treatment, he developed seizures and tremors. He is drinking water heavily and had recurrent episodes of urination. Which drug is responsible for these complications:
March 2012
| A |
Lithium |
|
| B |
Clozapine |
|
| C |
Fluphenazine |
|
| D |
None of the above |
Ans: A i.e. Lithium
- Dose related side effects of lithium includes polyuria/polydypsia, weight gain, tremor etc.
- Common side effects of clozapine are anticholinergic, antiadrenergic etc. Potentially life threatening side effects includes fatal agranulocytosis, fatal myocarditis, fatal pulmonary embolism etc.
- Side effect of antipsychotic, include sedation, weight gain, extra-pyramidal side effects, postural hypotension etc.