Summary
Samenvatting Stemmingsstabilisatoren
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Samenvatting van 3 pagina's voor het vak Minor aan de HHS
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2. Stemmingsstabilisatorenindeling:
1. unipolair: alleen depressieve episoden
2. bipolair: zowel depressieve als manische episoden
behandeling:
1. unipolair: antidepressiva HC3
2. bipolair: stemmingsstabilisatoren HC2
definitie stemmingstabilisator:
acuut effect, profylactisch effect, zowel manisch als depressieve episoden, geen
negatief effect een van beide polen.
Lithium : geen indeling
= belangrijkste middel, al gebruikt in de oudheid
werkingsmechanisme is onbekend
alternatieven over Lithium :
Manische episode:
1. anti-epilepticae : carbamazepine, valproinezuur
2. atypische antipsychotica: olanzapine, quetiapine
Depressieve episode:
1. anti-epileptica: lamotrigine
2. atypische antipsychotica: quetiapine
pas op met antidepressiva groter risico op manie!
Lithium
Indicaties volgens hulpgids
- behandeling en preventie manische episode
- behandeling therapieresistente depressie
- behandeling postpartumpsychose
therapieresistent = de gebruikelijke therapieën werken niet
postpartumpsychose = psychose na de bevalling
optreden van effect:
- acute fase: 1 tot 2 weken
- profylaxe: na 6 tot 12 maanden
effectiviteit:
- goed werkzaam bij acute manie
- echter 30-40% reageert niet of heeft teveel last van bijwerkingen
- tot 80% respons bij depressie
- echter vaak slechts gedeeltelijk
verloop behandeling met Lithium
1. behandeling manische of depressieve episode
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