Examkin

Question

Difficulty: EasyBipolar and Related Disorders

Match each pharmacological agent used in psychiatric practice with its characteristic adverse effect profile or specific clinical warning regarding its use in bipolar disorder.

  • LithiumRequires baseline and periodic monitoring of serum creatinine and thyroid-stimulating hormone (TSH).
  • ValproateAssociated with dose-related thrombocytopenia, hepatotoxicity, and significant teratogenic risks (neural tube defects).
  • QuetiapineAn atypical antipsychotic associated with significant weight gain, dyslipidemia, and insulin resistance; requires regular metabolic monitoring.
  • SertralineAn antidepressant that carries a high risk of precipitating a manic switch if used as monotherapy in patients with bipolar depression.

Answer

Lithium pairs with renal/thyroid monitoring; Valproate pairs with hepatotoxicity and neural tube defects; Quetiapine pairs with metabolic syndrome monitoring; Sertraline pairs with the risk of precipitating a manic switch.
Each medication plays a specific role in psychiatric care and has a uniquely identifiable risk profile. Lithium affects the kidneys and thyroid. Valproate affects the liver and platelets, and is teratogenic. Quetiapine causes metabolic derangements. Sertraline, while an effective antidepressant, can dangerously precipitate mania in bipolar patients.

Step-by-Step Solution

1
Evaluate the specific organ toxicity and monitoring requirements for the classic mood stabilizers.
Lithium requires renal (creatinine) and thyroid (TSH) monitoring. Valproate requires hepatic function and platelet monitoring, and carries neural tube defect risks.
Mood stabilizers have distinct pharmacokinetic pathways and long-term toxicity profiles that are highly tested core concepts.
2
Identify the primary adverse effects of second-generation antipsychotics used in bipolar disorder.
Quetiapine is strongly linked to weight gain, dyslipidemia, and hyperglycemia.
Atypical antipsychotics are central to bipolar treatment, but their metabolic effects necessitate strict longitudinal monitoring.
3
Determine the clinical consequence of using unopposed antidepressants in a patient with bipolar disorder.
Sertraline (an SSRI) can induce a manic switch if given without a concurrent mood stabilizer.
Antidepressant monotherapy is a classic prescribing error in patients with bipolar depression.

Key Concept

Pharmacological management of bipolar disorder: adverse effects, monitoring guidelines, and contraindications.
Rate this question

Topics

Bipolar and Related Disorders

More questions from this topic