MOOD STABILIZER
This Assignment is designed to help you analyze the many considerations for prescribing mood stabilizers, as well as organizing the many different lab components to consider when prescribing to a patient.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE
- Review the Required Learning Resources.
- Review indications and considerations for traditional mood stabilizer psychopharmacology treatments, including carbamazepine, lamotrigine, lithium, and valproate products.
THE ASSIGNMENT
Construct a 5- to 6-page paper discussing each of the four traditional mood stabilizer medications: carbamazepine, lamotrigine, lithium, and valproate products. Support your answers with five (5) evidence-based, peer-reviewed scholarly literature.
Note: APA style format will apply.
Your paper should include the following for each:
- Proposed mechanism of action
- Baseline assessment, laboratory considerations, and frequency of ongoing labs and assessments
Note: Discuss the importance of assessment and labs. - Special population considerations (birth assigned gender, age, other medical comorbidity considerations)
- FDA approval indications
- Typical dosing with discussion on therapeutic endpoints for psychiatric use
- Major drug–drug interaction considerations
- For each of these medications, please review potential drug–drug interactions listed below. Consider alternative dosing schedules, clinical implications for the drug interactions, additional patient education needed, any additional monitoring recommended, or collaboration needed with other medical professions (such as, primary care providers)
- Lamotrigine + Valproate
- Lamotrigine + Rifampin
- Valproate + Estrogen containing birth control.
- Valproate + Amitriptyline
- Lithium + Furosemide
- Lithium + Lisinopril
- Carbamazepine + Lurasidone
- Carbamazepine + Grapefruit juice
- Discuss the ethical, legal, and social implications related to prescribing bipolar and other related mood-disorder diagnoses therapy for patients.
- For each of these medications, please review potential drug–drug interactions listed below. Consider alternative dosing schedules, clinical implications for the drug interactions, additional patient education needed, any additional monitoring recommended, or collaboration needed with other medical professions (such as, primary care providers)
Answer
Mechanism of Action
Carbamazepine modulates inactivated voltage-gated sodium channels (VGSC) to inhibit repetitive action potentials and lower synaptic transmission, stabilizing mood and treating seizures (Goldin, 2023). Lamotrigine selectively binds and inhibits VGSC to stabilize the presynaptic neuronal membrane and inhibit the presynaptic release of aspartate and glutamate (Nath & Gupta, 2023). It also modulates serotonin, dopamine, and norepinephrine (Goldin, 2023). Lithium modulates muscle and nerve cell sodium transportation, impacts the serotonin and catecholamine metabolism, inhibits inositol monophosphate to alter intracellular signaling pathways, and reduces protein kinase C activity, modifying neurotransmission-related gene expression (Chokhawala et al., 2024). It also increases cytoprotective protein to trigger neurogenesis and increase the volume of gray matter (Nath & Gupta, 2023). Valproate (Valproic acid) inhibits gamma-aminobutyric acid (GABA) degradation and increases its release and activity (Rahman et al., 2023). It also blocks VGSC, calcium, and potassium channels to increase neuronal firing, modulates signaling systems to impact arachidonate and inositol metabolism, and modulates gene expression (Goldin, 2023)…….