A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients with bipolar disorder? (Select all that apply.)

Choice A Reason:Valproate (Depakote) is a mood stabilizer commonly used in the treatment of bipolar disorder. It helps to control manic and mixed episodes and can also prevent the recurrence of these episodes. Valproate works by increasing the levels of gamma-aminobutyric acid (GABA) in the brain, which has a calming effect on nerve activity.Choice B Reason:Carbamazepine (Tegretol) is another mood stabilizer that is effective in treating manic episodes in bipolar disorder. It is particularly useful in individuals with rapid cycling bipolar disorder and those who have not responded well to lithium. Carbamazepine works by decreasing nerve impulses that cause seizures and pain, which also helps to stabilize mood.Choice C Reason:Lithium (Eskalith) is one of the most well-known and frequently prescribed medications for bipolar disorder. It is effective in reducing the severity and frequency of mania and may also help to alleviate or prevent bipolar depression. Lithium is thought to work by stabilizing the cell membranes and influencing the synthesis and release of certain neurotransmitters.Non-Selected Choices Reason:Donepezil (Aricept) is not used for bipolar disorder; it is used to treat symptoms of Alzheimer's disease. Paroxetine (Paxil) is an SSRI antidepressant that may be used to treat depressive episodes in bipolar disorder, but it is not a primary treatment for bipolar disorder itself and must be used cautiously to avoid inducing mania.