Mood Stabilizer- wk 8

Mood Stabilizer Name Institution Course and Code Professor Date Mood Stabilizer Introduction Mood stabilizers are crucial when it comes to bipolar disorder as well as other mood disorders to avoid episodes of mania or depression. Carbamazepine, lamotrigine, lithium, and valproate are perhaps the most frequently used mood stabilizers due to their efficacy. Therefore, the action, dosing, and monitoring are different in each medicine, hence the need to understand them for therapeutic application (Appel, 2023). This paper discusses the four drugs: their actions, how they are evaluated, various considerations concerning demographic attributes, formal uses as endorsed by the FDA, typical methods of dosing, and most essential drug-drug interactions. Highlighting the potential ethical, legal, and societal ramifications involved with the prescription of these medications will reiterate the necessity of a more holistic, patient-centered approach to therapy. Carbamazepine Proposed Mechanism of Action According to Grunze et al. (2021), action is achieved by blocking voltage-gated sodium channels, to help regulate neuronal activity that is elevated in mood disorders and subsequently regulates mood. Thus, this process contributes to stabilizing mood and brain activity thanks to the elimination of solid stimulants such as glutamate. Baseline Assessment, and Laboratory Considerations, The valuations approved for carbamazepine commencement comprise of kidney function tests (KFTs), complete blood count (CBC), and liver function tests (LFTs). The management entails CBC and LFT checks, which will be conducted once every two weeks for the initial two months and after every 3 months to assess for any tendencies of bone marrow suppression or hepatotoxicity (Grunze et al., 2021). Routine monitoring is essential to ensure that the medication is effective for treating the condition and to ensure the patient's safety. Special Population Considerations Carbamazepine is assigned to Category D medication for pregnant women attributed to teratogenic risks (Grunze et al., 2021). Elderly people may require low dosages because of decreased efficiency of metabolic clearance. Since medication metabolism and excretion are affected by hepatic or renal disorders, patients in these categories need to have their medication intake more frequently scrutinized and adjusted as needed. FDA Approval Indications The FDA has given carbamazepine an endorsement of bipolar disorder management, especially the severe manic and mixed phases (Grunze et al., 2021). However, usage is allowed for trigeminal neuralgia and epilepsy. These approvals have clarified its efficiency in managing neuropathic pains and controlling moods. Typical Dosing Patients with bipolar disorder should initiate lithium at 200 mg bid, with dose escalation to a commonly used target dose of 800-1200 mg/day (Grunze et al., 2021). Clinician-rated and self-reported changes in manic and mood states are instances of therapeutic goals that are operative in bipolar treatment. Major Drug-Drug Interaction Considerations Carbamazepine + Lurasidone- Lurasidone's metabolism is induced by carbamazepine, which may lessen its effectiveness. It could be required to switch to a different antipsychotic or adjust the dosage of lurasidone. Carbamazepine + Grapefruit Juice- Grapefruit juice raises the risk of toxicity and carbamazepine levels by inhibiting the CYP3A4 enzyme. Patients should avoid grapefruit juice to avoid side effects such as nausea, ataxia, and dizziness. Lamotrigine Action Mechanism Lamotrigine is utlized as an anticonvulsant and for stabilizing moods, reducing the release of glutamate and aspartate when sodium channels are voltage-sensitive. Besag et al. (2021) note that by damping excessive activity in the brain, which is linked with bipolar disease and moods, this helps in mood stabilization. Baseline Assessment, and Laboratory Considerations The baseline tests for lamotrigine range from taking a detailed medical history and investigating the liver to kidney functions. Lamotrigine has an advantage over other mood stabilizers for patients with relatively lower req...