Medication Dosage and Administration
The most important bipolar disorder drugs to be monitored regularly include the following mood stabilizers and tricyclic antidepressant:
Lithium Depakote, Depakene (sodium valproate, valproic acid) Nortriptyline Tegretol (carbamazepine)
The therapeutic levels of these drugs are dependent upon the half-life of the drugs as determined by the serum blood test. After test results are taken, proper dosage and administration of these mood stabilizers can commence. After your blood test is administered, usually by a phlebotomist in a lab setting, your results will be shared with your doctor who will determine if the amount of medication and the frequency with which you take them should be changed. If your medication dosage is off you could experience symptoms that include mood swings or manic episodes, the very thing your psychoactive drugs are meant to prevent.
How Long Does It Take to Reach Therapeutic Levels?
From your serum blood test, your medical provider should be able to determine how many hours or days it will take for the medicine to reach therapeutic levels. While some medications have a half-life of only 1-4 hours, such as acetaminophen, some mood stabilizers have a half-life of 1-2 days. The longer the half-life of the drug, the longer it will take to reach a therapeutic level, i.e. for the drug to take effect. While Tegretol (carbamazepine) has a variable half-life (initial half-life values range from 25-65 hours, decreasing to 12-17 hours on repeated doses), it also causes auto-induction of metabolism, so an initially therapeutic blood level can drop and that is why serum levels need to be followed more frequently initially with this medication. As you and your family members work through your diagnosis, be sure to keep track of your medications and have someone equally accountable for you so that you don’t miss a dose and render your medication ineffective, or worse risk too much medication in your blood, which could be toxic.
