Question

A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. The nurse explains to the client that the rationale behind this regimen is that the antipsychotic has which action?

1) Potentiates the action of lithium for more effective results
2) Interacts with lithium to prevent progression to the depressive phase
3) Helps decrease the risk of lithium toxicity in the first week of therapy
4) Acts to quiet the client while allowing time for the lithium to reach a therapeutic level

Answer 1

An antipsychotic agent is used alongside lithium carbonate in treating bipolar I disorder to quickly manage psychosis symptoms and to quiet the patient while the lithium reaches therapeutic levels.

Step-by-step explanation:

The rationale behind using an antipsychotic agent alongside lithium carbonate in the treatment of bipolar I disorder, manic episode, is predominantly due to the immediate action of antipsychotics in managing psychosis symptoms such as delusions and agitation. Antipsychotics work by blocking dopamine receptors, thereby reducing overactive dopamine neurotransmission which can be associated with these symptoms. As a result, option 4 is generally the most accurate – the antipsychotic acts to quiet the client while allowing time for the lithium to reach a therapeutic level. Lithium, a mood stabilizer, then helps in the overall management of bipolar disorder by stabilizing mood fluctuations.