AIIMS Rishikesh & Jodhpur NO - 2017
Pharmacology
Easy
Which of the following is not a mood stabilizing agent?
Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017
Explanation
- Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI), a class of antidepressants.
- Its primary function is to treat depressive disorders by increasing serotonin levels in the brain.
- It is not classified as a mood stabilizer because it does not prevent manic episodes.
- In patients with bipolar disorder, using an SSRI like fluoxetine without a concurrent mood stabilizer can increase the risk of switching from depression to a manic or hypomanic state.
Why Other Options Were Wrong
- Option B: Lithium carbonate is the quintessential mood stabilizer, often considered the 'gold standard' for treating bipolar disorder.
- Option C: Valproic acid is an anticonvulsant that is also widely used and approved as a first-line mood stabilizer for bipolar disorder.
- Option D: Clonazepam is a benzodiazepine, not a mood stabilizer. However, the question asks for a single best answer. While clonazepam is not a mood stabilizer, fluoxetine represents a different primary drug class (antidepressant) that is fundamentally contrasted with mood stabilizers in bipolar treatment guidelines.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification of psychotropic drugs, specifically mood stabilizers versus other classes like SSRIs and benzodiazepines as background academic context rather than a clinical decision trigger.
- A critical nursing responsibility is understanding drug classifications to ensure patient safety. Administering an SSRI like fluoxetine to a patient with undiagnosed bipolar disorder can precipitate a manic episode, causing significant distress and potential harm.
- Nurses must be vigilant in monitoring patients starting on antidepressants for signs of hypomania or mania, such as elevated mood, decreased need for sleep, and increased energy, and report these changes to the prescriber immediately.
- What if? If a patient with bipolar I disorder, currently stable on lithium, presents with a major depressive episode, a psychiatrist might cautiously add an antidepressant like fluoxetine, but only with the mood stabilizer already in place to prevent a switch to mania. The antidepressant would be used for the shortest effective duration.
How to Approach the Question
- First, read the question carefully and note the negative keyword 'not'. The goal is to find the drug that does NOT belong to the 'mood stabilizer' class.
- Second, review each option and recall its primary drug classification and use.
- Lithium carbonate: Classic mood stabilizer.
- Valproic acid: Anticonvulsant also used as a mood stabilizer.
- Fluoxetine: SSRI antidepressant.
- Clonazepam: Benzodiazepine anxiolytic.
Concept Tested & Keywords
- Concept Tested: Pharmacological classification of psychotropic drugs, specifically mood stabilizers versus other classes like SSRIs and benzodiazepines.
- Stem keywords: mood stabilizing agent
- Lead-in keywords: not
- Negative lead-in flag: The question asks to identify the option that is NOT a mood stabilizer.
Question ID
QTiYqJIoi1cLGhFSb9ScF-
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 10753-10755, 10752-10754
E6 Pharmacology Katzung 16e p. 826-828
Practise the full AIIMS Rishikesh & Jodhpur NO - 2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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