Question

Multiple-choice question: If a patient has been diagnosed with a manic disorder, the nurse anticipates that the physician will most likely prescribe: A. Clonazepam (Klonopin) B. Lorazepam (Ativan) C. Imipramine (Tofranil) D. Lithium (Lithobid)

Short answer

D. Lithium (Lithobid)

Step-by-step solution

Understanding Manic Disorders

Manic disorders, which are a component of bipolar disorder, often involve periods of excessively elevated or irritable mood and heightened energy or activity levels. During these episodes, patients may struggle with decision making, may engage in risky behaviors, and may experience hallucinations or delusions in severe cases.

Identifying the Treatments

Therapeutic treatments for manic disorders generally consist of mood stabilizers, antipsychotics, or sometimes benzodiazepines in the short term. Therapies such as cognitive behavioral therapy, family-focused therapy, or interpersonal and social rhythm therapy may also be used in conjunction.

Finding the correct medication

Among the options given: A. Clonazepam (Klonopin) and B. Lorazepam (Ativan) are benzodiazepines, typically used to treat anxiety and sometimes used as a short term treatment for manic symptoms until other medications can take effect. C. Imipramine (Tofranil) is a tricyclic antidepressant, more commonly used for depression. D. Lithium (Lithobid) is a mood stabilizer, frequently used specifically in the treatment of manic disorders.

Selecting final answer

Lithium (Lithobid), being a mood stabilizer, is most likely to be prescribed by the physician for a patient with a manic disorder. So, the correct answer is D. Lithium (Lithobid).

Key concepts

Understanding Manic Disorders

Manic disorders are a significant aspect of bipolar disorder, often characterized by extreme mood swings. These include episodes of mania and can range from euphoria and boundless energy to irritability and aggression. During manic episodes, individuals may find themselves struggling with:

• Overconfidence in their abilities
• Making impulsive decisions
• Engaging in risky behaviors such as excessive spending or reckless driving
• Experiencing hallucinations or delusional thoughts, mainly when the mania is severe

Early intervention and effective management are essential to mitigate potential negative impacts on a person's life and relationships.

Exploring Mood Stabilizers

Mood stabilizers serve as the cornerstone in managing manic disorders. These medications help in maintaining a balanced mood by preventing the onset of manic and depressive episodes. Lithium is one of the most well-known mood stabilizers and has been used for decades due to its effectiveness in treating mania and providing long-term mood stabilization. Other mood stabilizers may include:

• Valproate (Depakote)
• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)

These drugs often require regular monitoring of blood levels to avoid toxicity, and the dosages need to be adjusted to meet the individual needs of the patient.

Therapeutic Treatments for Manic Disorders

Alongside medication, therapeutic treatments are crucial in managing manic disorders. These therapies aim to provide patients with the tools and strategies needed to cope with their symptoms and improve their quality of life. Key therapeutic interventions include:

• Family-focused therapy, which involves family members in the treatment process to improve communication and support
• Interpersonal and social rhythm therapy, which focuses on regulating daily habits to prevent mood episodes
• Psychoeducation, which helps patients and their families understand the disorder, fostering better adherence to treatment plans and lifestyle changes

These interventions, together with medication, form a comprehensive approach to managing manic disorders.

Cognitive Behavioral Therapy (CBT) in Manic Disorders

Cognitive Behavioral Therapy (CBT) is a valuable therapeutic approach in handling manic disorders. CBT works by modifying dysfunctional thoughts, emotions, and behaviors. It helps individuals:

• Identify and change negative thought patterns that contribute to manic symptoms
• Develop problem-solving and coping strategies for stressful situations
• Increase awareness about triggers that might lead to manic episodes

By incorporating CBT into the treatment plan, patients can gain better control over their emotions and actions, reducing the frequency and severity of manic episodes. CBT complements medication and other therapies, providing a holistic approach to treatment.