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Bipolar Disoder

The document discusses two antidepressant drugs, fluoxetine and venlafaxine. Fluoxetine has a nonlinear pharmacokinetic profile and its metabolite norfluoxetine has a half-life ranging from 7 to 15 days. Venlafaxine is well absorbed with a half-life of 3-5 hours and is metabolized into desvenlafaxine with a half-life of 9-11 hours.

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53 views3 pages

Bipolar Disoder

The document discusses two antidepressant drugs, fluoxetine and venlafaxine. Fluoxetine has a nonlinear pharmacokinetic profile and its metabolite norfluoxetine has a half-life ranging from 7 to 15 days. Venlafaxine is well absorbed with a half-life of 3-5 hours and is metabolized into desvenlafaxine with a half-life of 9-11 hours.

Uploaded by

Mompati Letsweletse
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Fluoxetine Venflaxine

well absorbed after PO admin, is highly well absorbed, with at least 92% of an PO . The
protein bound, & VD→ 30-40 L/kg. The primary route of excretion of venlafaxine and its
elimination half-life of fluoxetine is about 1 metabolites is via the kidneys dose being absorbed
to 4 days, while that of its metabolite into systemic circulation.T1/2—3-5 hrs . Venlafaxine is
norfluoxetine ranges from 7 to 15 days. metabolized into desvenlafaxine Metabolite- T1/2-9-
11hrs

Fluoxetine has a nonlinear


pharmacokinetic profile. ∴, should be used
with caution in Pt wt a ↓ metabolic
capability (i.e. hepatic dysfunction).

Available as a sustained-release
preparation allowing once-weekly dosing.
Hepatic microsomal enzyme inhibitor

Drug Selection
Acute Therapy: Manic Episodes. Two mood stabilizers—
lithium and valproate—are preferred drugs for acute management
of manic episodes in combination with a second-generation
(atypical) antipsychotic medication. Lithium is the drug of
choice. If the patient does not respond adequately to lithium
or valproate alone, the drugs may be used together. Responses
to mood stabilizers develop slowly, taking 2 or more weeks
to become maximal.
Seven second-generation antipsychotic medications are
approved for the management of acute manic or mixed episodes
occurring in bipolar depression. These medications are often
used for short-term management of severe mania as adjunctive
therapy to the mood stabilizers. Table 33.1 lists common dosages
for treatment.
If needed for episodes of severe mania, a benzodiazepine
(e.g., lorazepam [Ativan]) may be added to the regimen for
acute management of symptoms (insomnia, anxiety, agitation).
For patients with hypoactive mania an antipsychotic may be
employed as monotherapy;

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