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Old 10-29-2010
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Psyche Bipolar Disorder and Seizures

A 40 yo female with prior hx of polar disorder is admitted to hospital after motor vehicle accident. She develops tonic clonic seizures. Which of the following would be most helpful in treating both of her conditions in long run?
A lorazepam
B valproic acid
C sertraline
D olanzapine
E litium
F ethosuximide
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I think it is B
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Old 10-29-2010
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one of few anticonvulsant drugs which can be used in bipolar is valproic acid.

other is carbamazepine. ans is B.
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Old 10-29-2010
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Dont forget Lamotrigine

http://en.wikipedia.org/wiki/Lamotrigine
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Old 10-29-2010
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This has something to do with gaba receptors. Let me see if I can explain it.
Inhibitor of gaba uptake tiagabine
Blocks sodium channels and enhances the effect of gaba topiramate
Inhibits gaba-transaminase and increases gaba concentration vigabatrin
Increases brain gaba concentration gabapentin
The answer is B valproic acid. It decreases propagation of abnormal action potentials by enhancing inhibitory action of gaba in cns. Valproic acid is effective for absence, myoclonic, and generalized tonic-clonic seizures. Also, valproic acid is used to prevent mania in bipolar disorder, in mixed manic-depressive disorder, and management of acute mania. Other mood stabilizers and anticonvulsant is carbamazepine. I was not aware of lamictal.
In addition, doc for myoclonic seizure is valproic acid, but ethosuximide is preferred in absence seizure.

I am excited to post daily questions, and thanks for the stimulation you folks have generated
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Old 09-21-2013
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The good choice is B,because Valporic acid is a very good option for management of tonic clonic seizure.
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