psychiatric disorders
Medications for Treatment of Bipolar Disorders
Antiseizure Medications
Antiseizure medications that act as mood stabilizers, especially valproate andcarbamazepine, are often used for acute mania and for mixed states (mania and depression).Lamotrigineis effective for mood-cycling and for depression. The precise mechanism of action for antiseizure medications in bipolar disorder is unknown but may involve gamma-aminobutyric acid mechanisms and ultimately G-protein signaling systems. Their main advantages overlithiuminclude a wider therapeutic margin and lack of renal toxicity. For valproate, the initial dose and route of administration may vary, but it requires adjustment based on target serum levels. A loading-dose protocol based on weight may result in earlier symptom improvement. Adverse effects include nausea, headache, sedation, dizziness, and weight gain; rare serious effects include hepatotoxicity and pancreatitis. Carbamazepineshould not be loaded; it should be increased gradually to achieve a target serum level. Adverse effects include nausea, dizziness, sedation, and unsteadiness. Very severe effects include aplastic anemia and agranulocytosis. can cause rash and, rarely, the life-threatening Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) , particularly if the dosage is increased more rapidly than recommended. While taking 