Antipsychotics mood stabilisers

Tom, 40, has schizoaffective disorder. You restarted his regular medications on admission, 3 weeks ago an antipsychotic, mood stabiliser and antidepressant He s asked to see you about side effects. 

The term mood stabiliser has been applied to lithium and antieonvulsant dmgs used to treat bipolar disorder. It is also starting to be applied to some atypieal antipsychotics. Its use has become more controversial with developments in anticonvulsant and atypical antipsychotic use in bipolar disorder. 

Table A.l Overview of physical health monitoring in Severe Mental illness tSMii Table A.2 Delirium investigations Table A.3 First episode psychosis investigations Table A.4 Baseline checks before starting psychotropics Table A.S Ongoing monitoring - antipsychotics Table A.6 Ongoing monitoring - mood stabilisers Table A. 7 Rapid tranquilisation tRTi cautions and contraindications Table A. 8 Monitoring after RT Appendix B Medications...

Antipsychotics are also used for mood stabilisation in acute mania or BPAD prophylaxis (e.g. aripiprazole, olanzapine, risperidone, quetiapine). They require the usual antipsychotic monitoring. Some offer IM options and none need drug levels, which can help when people are acutely uncooperative or chaotic. 

Olanzapine, aripiprazole, risperidone, quetiapine (p57-9. Appendices B1 2) - effective mood stabilisers, but carry antipsychotic risks and monitoring needs... 

If relevant (and not pregnant), restart Josie s regular mood stabiliser/antipsychotic... 

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