Bipolar Flashcards
• Describe a manic episode and differentiate it from hypomania or a primary psychotic episode • Differentiate between Bipolar I, Bipolar II and Cyclothymia • List common medications, medical conditions and environmental changes associated with mania
age of onset in bipolar
20s
more severe bipolar (1/2)
2
prevalance of bipolar
1% lifetime prevalence
gender distribution in biolar
equal in I, more females in II
define hypomania
manic sx without psychotic sx
predictor of poor outcome in bipolar
psychotic mania
worsens the course of Bipolar
substance abuse
causes of mania after age 40
drugs, steroids, brain trauma, HIV, stroke, MS, epilepsy, tumor
precipitants for mania (7)
post-partum state, sleep deprivation, dopamine agonists, antidepressents, stroke/brain injury, jet lag, severe stress
hypomaniac pts are diagnosed with what type of bipolar
II
do pts know they are having a manic episode?
no, usually the behaviour is brought to their attention
rapid cycling definition
4 or more mood episodes a year
define dysphoric mania
depression and mania smultaniously
more common: depression or mania
depression
more likely to be depressed: bipolar 1 or 2
2
more likely to be asymptomatic at any given time, 1 or 2
1
possible first sign of bipolar in teens
atypical depression
may result from Li+ use
hypothyroidism
can mimic depression
hypothyroidism
risk of antidepressents in bipolar
can bring about manic episode
definition of cyclothymia
2 years of hypomania and numerous periods of depressive sx that do not meet criteria for major depression
chance of a bipolar pt having substance addiction
50%
manic sx
inflated self esteem, decreased need for sleep, distractability, rapid speech, racing thoughts, increased goal directed behavior, excessive involvement in pleasurable activites
acroym for manic sx
DIGFAST
DIGFAST
distractable increased activity grandiosity flight of ideas (racing thoughts) activites that are dangerous or hypersexuality sleep decreased talkative speech
definition of bipolar 1
manic episode, with or without episode of major depression
definition of bipolar 2
major depression and hypomania
dx criteria of bipolar 1
one manic episode (because 90% are going to have a depressive episode at some point(
dx criteria of bipolar 2
hypomania and an episode of major depression
distinguishes schizophrenia from bipolar
schizophrenia thoughts are mopre fragmented and bizzare with less intense affect
areas in the brain effected by bipolar
PFC, Ventrat tegmental area, periaqueductal grey matter, basal ganglia
define kindling in bipolar
idea that each episode makes it easier to have a subsequent episode
3 bipolar classic mood stabilizers
lithium, valproic acid, carbamazepine
6 2nd gen mood stabilizers
aripirazole, quetiapine, risperidone, ziprasidone, olanzapine
drug combo for bipolar depression
fluoxetine-olanzaoine
serious condition that lamotrigrine can cause
steven-johnson syndrome
appoved for maintaince in bipolar
lamotrigine
