Lithium is the drug of choice for?

Appeared in: NHM UP Staff Nurse - 2016

Explanation

Lithium is a mood-stabilizing medication, and its primary FDA-approved indication is for the treatment of bipolar disorder.
It is highly effective in controlling the symptoms of an acute manic episode, such as euphoria, hyperactivity, and grandiosity.
Lithium is also used as a long-term maintenance therapy to prevent the recurrence of both manic and depressive episodes in individuals with bipolar disorder.
While the onset of action is slow (1-2 weeks), it remains a cornerstone of treatment for classic euphoric mania.

Option A: Acute agitation in schizophrenia is a psychotic symptom. Lithium is a mood stabilizer, not an antipsychotic, and is not the first-line treatment for this condition.
Option B: A paranoid state is a form of psychosis characterized by delusions of persecution. The primary treatment for psychosis involves antipsychotic medications.
Option C: While lithium has some antidepressant effects and can be used to augment antidepressants, it is not the first-line drug of choice for treating an acute depressive episode in bipolar disorder.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology: Indications for Lithium Therapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility is educating patients on the signs of lithium toxicity and the importance of regular blood tests to ensure safety.
Nurses must teach patients to maintain a consistent intake of salt and fluids (2-3 L/day), as dehydration or low sodium levels can cause lithium levels to rise to toxic concentrations.
Patients should be advised to avoid NSAIDs (like ibuprofen) and certain diuretics, as these can increase lithium levels.

How to Approach the Question

First, identify the drug mentioned in the stem: Lithium.
Recall the primary drug class and indication for Lithium. It is a mood stabilizer.
Evaluate each option based on this primary indication.
Option A (Schizophrenia) and B (Paranoid state) relate to psychosis, primarily treated with antipsychotics.
Option C (Depressive phase) is a possibility, but recall that lithium is more for mania and maintenance, or augmentation in depression.
Option D (Manic episode) directly matches the primary, classic indication for lithium therapy. This makes it the strongest answer.

Concept Tested & Keywords

QN9BFZYUpGMyvB-0k2UXkq

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2049-2051

E6 Pharmacology KD Tripathi Essentials 9e Part 2 pp. 118-120, 115-117

Practise the full NHM UP Staff Nurse - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.