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lithium or valproic-1st line

Discussion in 'Psychiatry' started by golfpropsychguy, May 15, 2007.

  1. golfpropsychguy

    golfpropsychguy 2+ Year Member

    May 9, 2007
    Hey guys-quick question. Kaplan has written that Lithium is first line and valproic acid is second line treatment for Bipolar disorder. Crush has written that lithium and Valproic are 1st line. Boards and wards has written that Valproic is 1st line and lithium is second line.

    I basically just want the right answer for step 2.

    Can anyone help?
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  3. Anasazi23

    Anasazi23 Your Digital Ruler Moderator Emeritus 10+ Year Member

    Depends on the patient, but I think LiCo3 is the right answer for test purposes.
  4. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Physician Moderator Emeritus SDN Advisor 10+ Year Member

    Dec 2, 2004
    Left of Center
    According to the APA Practice Guidelines, both are first line. I imagine that the right answer for Step 2 may take into account issues of comorbid liver or kidney badness if it forces you to choose between the two.
  5. Anasazi23

    Anasazi23 Your Digital Ruler Moderator Emeritus 10+ Year Member

    ...and if it's a mixed episode.

    You're more likely to be asked which mood stabilizer is the only one statistically proven to reduce suicide. :)
  6. Teufelhunden

    Teufelhunden 1K Member Physician 10+ Year Member

    Nov 7, 2000
    Avon, Ohio
  7. whopper

    whopper Former jolly good fellow Physician Faculty 10+ Year Member

    Feb 8, 2004
    I hate when this bull happens.

    I remember several times in kaplan books, one section said one answer was the right thing to do in an exact situation.

    Then another section, pretty much almost the same question & situation, and then the answer is different--and this section's written by a different author.

    So what's the right answer!?!?!?

    I'd go with the APA answer. You got to remember that some of these study guides were written by people who aren't much higher than yourself. Maybe they're just a few years ahead.

    Man I am so glad I'm done with USMLE for this reason. I hated that bull.
  8. DrIng

    DrIng Senior Member 7+ Year Member

    Jul 20, 2003
    Don't forget the impact of things like breastfeeding or pregnancy on which you would use...

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