Key features of depression
and its management in general practice. |
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"..I've
been possessed by the devil"
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| Which
of the following statements are true in relation to withdrawal of
Omar from his antidepressants? |
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1.
Carbamazepine is effective as long term prophylaxis. |
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2.
Sodium valproate is now used widely for maintenance treatment. |
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3.
Angiotensin converting enzyme inhibitors may cause lithium toxicity
in people taking the drug. |
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4.
Omar should have his thyroid function monitored every 6 to 12 months. |
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5.
Cessation of lithium should be gradual, over at least 1 to 2 months. |
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4.
Omar should have his thyroid function monitored every 6 to 12 months.
Author's
answer: True
It
is important to assess renal and thyroid function prior to commencing
lithium. Lithium is excreted by the kidney and impaired renal function
will decrease lithium elimination and require reduced doses. Serum lithium
concentration should be measured every 1 to 3 months after stable therapeutic
concentrations are achieved. Renal function with serum creatinine and
electrolytes should be monitored every 3 to 6 months. Thyroid function
including TSH should be monitored every 6 to 12 months.
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