bipolar

Question 1

What is acute mani

Answer 1

One episode of mania

Question 2

What is bipolar affective disorder

Answer 2

2 episodes of mania

One episode of mania, one of depression

Question 3

What is recurrent depressive disorder

Answer 3

Two episodes of depression

Question 4

biological treatment of acute mania

Answer 4

Consider lithium or valproate
Stop antidepressants
Offer an antipsychotic: haloperidol, olanzapine, risperidone or quetiapine (1st line)
Consider benzos like lorazepam or diazepam for behavioural disturbance

Question 5

Psychological treatment for acute mani

Answer 5

Psychoeducation

Formal psyhchological approaches unlikely to be appropriate in acute phase

Question 6

Social treatment of acute mania

Answer 6

Consider use of MHA
Calming, low stimulus environment
Advise not to make serious decisions whilst unwell
Consider inpatient admission
Advise to maintain relationships with carers

Question 7

Biological treatment of bipolar depression

Answer 7

Mood stabiliser e.g. lithium, valproate, lamotrigine or optimise the dose

Consider 2nd generation/atypical antipsychotic e.g. olanzapine or quetiapine

Antidepressant SSRI but needs to be used with anti manic agent

Question 8

psychological treatment of bipolar depression

Answer 8

CBT

Psychoeducation

Question 9

Social treatment of bipolar depression

Answer 9

work around inclusion
Carer support
Consider admission if risk
Support with education, training, employment

Question 10

Biological treatment of bipolar affective disorder

Answer 10

Avoid antidepressants. Never offer without a mood stabiliser
Offer lithium. If intolerable consider valproate or olanzapine instead