Bipolar

Question 1

Bipolar I vs Bipolar II

Answer 1

Differ by severity of mania, both have bouts of intense depression

• I: if severe mania that has required hospitalization
• II: if hypomania that does not affect social/work functioning

Question 2

Mania definition

Answer 2

Abnormally elevated or irritable mood for at least 1 week (or any duration if hospitalized)

Question 3

Mania dx

Answer 3

3 or more:

• inflated self-esteem
• sleeping less
• talkative
• jumping from one topic to another
• easily distracted
• increase in goal-directed activity
• involved in high-risk pleasurable activities

Question 4

Mood stabilizers that tx both mania and depresssion

Answer 4

Lithium
Valproic acid
Lamotrogine
Carbamazepine

Question 5

Antipsychotics role in bipolar

Answer 5

Can help stabilize mood when a pt w/ mania also has psychosis

Question 6

1st line for manic state

Answer 6

Valproic or lithium + antipsychotic

Question 7

1st line for bipolar depression

Answer 7

Lithium or lamotrigine

Question 8

Bipolar in pregnancy

Answer 8

Lamotrigine or SGAs (lorasidone)

Question 9

Lithium MOA

Answer 9

Moderating excitatory neurotransmitter glutamate and influencing reuptake of 5HT and/or NE

Question 10

Lithium SEs

Answer 10

GI upset, tremor, thirst, weight gain, polyuria, blue-gray skin, cogwheel rigidity

Question 11

Lithium counselling points

Answer 11

Stay hydrated
Take with food to decrease N
Do not change amount of salt in diet (affects levels)