bipolar Flashcards
definition
recurring mood disorder characterised by episodes of mania/hypomania
3 subtypes: bipolar I (1 or more mania episodes, may or may not have depressive episodes, bipolar II hypomania + depressive, no mania and cyclothymic disorder
manic episode
distractability
insomnia
grandiosity
flight of ideas
activities increased
speech more talkative
thoughtless
elevated mood for >1 week
hypomania >4 consecutive days
mood stabilisers
carbamazepine, lamotrigine, lithium CR, valproate
antipsychotics
aripiprazole, haloperidol, olanzapine, quetiapine, risperidone
first line for acute mania
risperidone (atypical antipsychotics preferred over mood stabilisers)
first line for acute bipolar depression
lamotrigine or lithium or quetiapine
lithium dose
600-900mg BD–TDS max 900-1800mg OD-TDS
lithium SE:
hypothyroidism
drowsiness
derm, acne, psoriasis
renal
tremor lethargy
sodium valproate dose
500-750mg/d OD-QDS max 60mg/kg/d
SE of sodium valproate
drowsiness, dizziness
thrombocytopenia
alopecia
pancreatitis
hepatotoxicity
monitor LFT, FBC
carbamazepine dose
100-400mg BD-QDS max 1200mg/d
SE of carbamazepine
GI, nausea, vomiting,
drowsiness, dizziness
thombocytopenia
hepatotoxicity
ataxia
hyponatremia
monitor Na, LFT, FBC
lamotrigine dose
max 400mg.d
lamotrigine SE
rash, blood dyscrasia
aripiprazole dose
10-15mg OD max 30mg OD
