Psych Vivas · Psychopharmacology — mood stabilisers
Mood stabilisers — levels, toxicity, teratogens and trials viva
Fellowship viva on mood-stabiliser mechanisms, levels, monitoring, toxicity, pregnancy hierarchy, interactions, and landmark evidence.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner places four drug cards (lithium, valproate, lamotrigine, carbamazepine) and a blank monitoring table. You must fill targets, key toxicities, pregnancy rank, and name BALANCE, Cipriani suicide, EURAP, HLA-B*1502 and EXTRIP in under a minute each.
Station structure
Time: 8–10 minutes. Depth: consultant teaching registrar. Expect accurate trough timing, pregnancy hierarchy, interaction traps, and named trials — not vague “monitor bloods.”[1][3]
References8ShowHide
- [1]Geddes JR, Goodwin GM, Rendell J, et al. Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial Lancet, 2010.PMID 20092882
- [2]Cipriani A, Hawton K, Stockton S, et al. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis BMJ, 2013.PMID 23814104
- [3]Nolen WA, Licht RW, Young AH, et al. What is the optimal serum level for lithium in the maintenance treatment of bipolar disorder? A systematic review and recommendations from the ISBD/IGSLI Task Force on treatment with lithium Bipolar Disord, 2019.PMID 31112628
- [4]Chung WH, Hung SI, Hong HS, et al. Medical genetics: a marker for Stevens-Johnson syndrome Nature, 2004.PMID 15057820
- [5]Decker BS, Goldfarb DS, Dargan PI, et al. Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup Clin J Am Soc Nephrol, 2015.PMID 25583292
- [6]Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry Lancet Neurol, 2011.PMID 21652013
- [7]McCormack M, Alfirevic A, Bourgeois S, et al. HLA-A*3101 and carbamazepine-induced hypersensitivity reactions in Europeans N Engl J Med, 2011.PMID 21428769
- [8]Gitlin M Lithium side effects and toxicity: prevalence and management strategies Int J Bipolar Disord, 2016.PMID 27900734