Bipolar Flashcards
What does CANMAT mean when it indicates something is a monotherapy?
That the agent has evidence for use as either a sole medication or as an adjunctive agent on a therapy that has already shown effect
Meaning of a adjunctive medication via CANMAT?
Only to be used in combo with a proven monotherapy or therapy combination that has been tested
Bipolar disorder is most commonly misdiagnosed as what?
MDD due to prevelance of depressive episodes in patients with BP. Patients also have difficulty remembering mania episodes
Is suicide risk increased in BP?
YES! one of the leading causes of death in patients with BP
What might indicate bipolar vs a unipolar disease?
Weight gain is more common vs weight loss
Hypersomnia and increased daytime napping, we see decreased sleep in early unipolar
Bipolar arises earlier (<25YO) and multiple previous occurances more likely
First line adjunctive non-pharm therapy for BP?
Psychoeducation
How long does someone have to be in a manic state to meet DSM criteria for mania?
1 full week of persistant symptoms of abnormal mood increased activity or other mania presentation
Mania episode definition?
3 (or 4 days if only “irritable”)
Following symptoms: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure of speech, increased goal directed activiyy, agitation, increased involvment in actiivity with high risk of painful consequences (thrill seeking I guess?)
what is akathesia commonly misstaken for?
Agitation, need to be careful about this when determining a patients mood state
First line agent for mania episode treatment? (short term)
Aripiprazole, lorazepam, loxapine, olanzipine
All as IM formuatlion except loxapine which is inhaled
Oral agents that are second line for mania episode? (short term)
Aresenipine (sublinual) and risperidone (ODT)
Time to improve in mania symptoms?
3-4 weeks of treatment
3 first line agents with good evidence for maintenance of prevention of any mood episode
Lithium, Quetipine, divalproex
First line combination therapies?
Everything is Li or DVP +
Quetiapine, aripiprazole, risperidone, asenapine
Aripiprazole has negative evidence for acute treatment of what?
for use in depression acute treatment