Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry and Elderly Medicine > Bipolar Affective Disorder > Flashcards

Bipolar Affective Disorder Flashcards

1
Q

What is Bipolar?

A

Part of the ‘mood/affective disorders’

Episodes of mania/hypomania and depression

Interspersed by periods of normal mood and functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aspects of BPAD

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epidemiology - BPAD

  • Sex ?
  • Average age of onset …. years
  • 90% before … years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates 10 – 15%
A
  • Sex: ♀ = ♂
  • Average age of onset 20 years
  • 90% before 30 years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates 10 – 15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology - BPAD

  • Sex: ♀ = ♂
  • Average age of onset 20 years
  • ….% before 30 years
  • Life time prevalence: …-…% general population
  • Lifetime competed suicide rates 10 – 15%
A
  • Sex: ♀ = ♂
  • Average age of onset 20 years
  • 90% before 30 years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates 10 – 15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Epidemiology - BPAD

  • Sex?
  • Average age of onset 20 years
  • 90% before 30 years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates … – ….%
A
  • Sex: ♀ = ♂
  • Average age of onset 20 years
  • 90% before 30 years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates 10 – 15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Epidemiology - BPAD

  • Sex: ♀ = ♂
  • Average age of onset … years
  • 90% before … years
  • Life time prevalence: ..-..% general population
  • Lifetime competed suicide rates 10 – 15%
A
  • Sex: ♀ = ♂
  • Average age of onset 20 years
  • 90% before 30 years
  • Life time prevalence: 1-3% general population
  • Lifetime competed suicide rates 10 – 15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aetiology of Bipolar

  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: …%
    • DZ twin concordance: …%
    • Heritability 60%
  • TRIGGERS
    • … stress
    • … disturbance
A
  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability 60%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aetiology of Bipolar

  • Strong … component
    • Increased risk if 1st degree relative affected (up to …%)
    • …Z twin concordance: 60%
    • …Z twin concordance: 20%
    • Heritability 60%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
A
  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability 60%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aetiology of Bipolar

  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability …%
  • TRIGGERS
    • Psychosocial …
    • Sleep …
A
  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability 60%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aetiology of Bipolar

  • Strong genetic component
    • Increased risk if … degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability …%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
A
  • Strong genetic component
    • Increased risk if 1st degree relative affected (up to 10%)
    • MZ twin concordance: 60%
    • DZ twin concordance: 20%
    • Heritability 60%
  • TRIGGERS
    • Psychosocial stress
    • Sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • 1+ manic episode (>… days)
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode (>… days)
      • 1 major depressive episode
    • (NO episodes of …)
A
  • BPAD Type I:
    • 1+ manic episode (>7 days)
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode (>4 days)
      • 1 major depressive episode
    • (NO episodes of mania)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • …+ manic episode (>7 days)
    • (With or without … … episode)
  • BPAD Type II:
    • 1+ … episode (>4 days)
      • 1 … … episode
    • (NO episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode (>7 days)
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode (>4 days)
      • 1 major depressive episode
    • (NO episodes of mania)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • 1+ manic episode (>…. days)
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ …. episode (>… days)
      • 1 major depressive episode
    • (…. episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode (>7 days)
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode (>4 days)
      • 1 major depressive episode
    • (NO episodes of mania)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ICD-10 - BPAD

  • …+ episodes
    • Manic
    • Hypomanic
    • Major depressive
A
  • 2+ episodes
    • Manic
    • Hypomanic
    • Major depressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DIG FAST medical mnemonic – symptoms of mania

  • D…
  • I….
  • Grandiosity
  • Flight of Ideas / racing thoughts
  • Action Increase – Excess Energy
  • S… changes – … need for …
  • Talkativeness – Pressure of Speech
A
  • DIGFAST
    • Distractibility
    • Indiscretion (Risk Taking Behaviour)
    • Grandiosity
    • Flight of Ideas / racing thoughts
    • Action Increase – Excess Energy
    • Sleep changes – Decreased need for sleep
    • Talkativeness – Pressure of Speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DIG FAST medical mnemonic – symptoms of mania

  • Distractibility
  • Indiscretion (… Taking Behaviour)
  • G….
  • F…
  • Action Increase – … Energy
  • Sleep changes – Decreased need for sleep
  • Talkativeness – … of Speech
A
  • DIGFAST
    • Distractibility
    • Indiscretion (Risk Taking Behaviour)
    • Grandiosity
    • Flight of Ideas / racing thoughts
    • Action Increase – Excess Energy
    • Sleep changes – Decreased need for sleep
    • Talkativeness – Pressure of Speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypomania

  • Elevated/irritable mood >… days
  • 3+ of: (4+ if mood …)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
A
  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does DIG FAST stand for?

A
  • Distractibility
  • Indiscretion (Risk Taking Behaviour)
  • Grandiosity
  • Flight of Ideas / racing thoughts
  • Action Increase – Excess Energy
  • Sleep changes – Decreased need for sleep
  • Talkativeness – Pressure of Speech

Acronym for Bipolar manic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define Hypomania

A
  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hypomania

  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased …/… of …
    • Increased …
    • Distractibility
    • I…
    • Increased … energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
A
  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hypomania

  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased …/…
    • Increased …/pressure of speech
    • Increased sociability
    • D…
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild …, … behaviour
  • Leading to some interference with … …
A
  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
22
Q

Hypomania

  • …/… mood >4 days
  • …+ of: (4+ if mood …)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
A
  • Elevated/irritable mood >4 days
  • 3+ of: (4+ if mood irritable)
    • Increased activity/restlessness
    • Increased talkativeness/pressure of speech
    • Increased sociability
    • Distractibility
    • Insomnia
    • Increased sexual energy, overfamiliarity
    • Mild reckless, irresponsible behaviour
  • Leading to some interference with personal function
23
Q

Define Mania

A
  • >1 week (or any duration if hospitalised)
  • Predominantly elevated/irritable mood
  • 3+ of: (4 if mood irritable)
    • Increased activity/restlessness
    • Foolhardy/reckless behaviour
    • Distractibility
    • Talkativeness/pressure of speech
    • Reduced need for sleep
    • Flight of ideas/subjective feeling of racing thoughts
    • Increased self esteem or grandiosity
    • Psychotic symptoms
  • Leading to severe interference with personal function
24
Q

Mania

  • >… … (or any duration if hospitalised)
  • Predominantly elevated/irritable mood
  • 3+ of: (4 if mood irritable)
    • Increased activity/restlessness
    • Foolhardy/reckless behaviour
    • D…
    • Talkativeness/pressure of speech
    • … need for sleep
    • Flight of ideas/subjective feeling of racing thoughts
    • Increased self esteem or grandiosity
    • … symptoms
  • Leading to severe interference with personal function
A
  • >1 week (or any duration if hospitalised)
  • Predominantly elevated/irritable mood
  • 3+ of: (4 if mood irritable)
    • Increased activity/restlessness
    • Foolhardy/reckless behaviour
    • Distractibility
    • Talkativeness/pressure of speech
    • Reduced need for sleep
    • Flight of ideas/subjective feeling of racing thoughts
    • Increased self esteem or grandiosity
    • Psychotic symptoms
  • Leading to severe interference with personal function
25
Q

Mania

  • >1 week (or any duration if hospitalised)
  • Predominantly …/…. mood
  • …+ of: (… if mood irritable)
    • Increased activity/restlessness
    • Foolhardy/reckless behaviour
    • Distractibility
    • Talkativeness/pressure of speech
    • Reduced need for sleep
    • Flight of ideas/subjective feeling of racing thoughts
    • Increased self esteem or grandiosity
    • Psychotic symptoms
  • Leading to severe interference with personal function
A
  • >1 week (or any duration if hospitalised)
  • Predominantly elevated/irritable mood
  • 3+ of: (4 if mood irritable)
    • Increased activity/restlessness
    • Foolhardy/reckless behaviour
    • Distractibility
    • Talkativeness/pressure of speech
    • Reduced need for sleep
    • Flight of ideas/subjective feeling of racing thoughts
    • Increased self esteem or grandiosity
    • Psychotic symptoms
  • Leading to severe interference with personal function
26
Q

Psychotic symptoms in mania

  • Delusions - usually mood-…
    • Grandiose (fame, wealth, power…)
    • Persecutory (if irritable)
  • Hallucinations
    • … person auditory
  • Formal … disorder
    • Circumstantiality
    • Tangentiality
    • … of ideas
  • Communication may be difficult!
A
  • Delusions - usually mood-congruent
    • Grandiose (fame, wealth, power…)
    • Persecutory (if irritable)
  • Hallucinations
    • 2nd person auditory
  • Formal thought disorder
    • Circumstantiality
    • Tangentiality
    • Flight of ideas
  • Communication may be difficult!
27
Q

Psychotic symptoms in mania

  • Delusions - usually mood-congruent
    • … (fame, wealth, power…)
    • … (if irritable)
  • Hallucinations
    • 2nd person auditory
  • … thought disorder
    • Circumstantiality
    • T…
    • Flight of ideas
  • Communication may be difficult!
A
  • Delusions - usually mood-congruent
    • Grandiose (fame, wealth, power…)
    • Persecutory (if irritable)
  • Hallucinations
    • 2nd person auditory
  • Formal thought disorder
    • Circumstantiality
    • Tangentiality
    • Flight of ideas
  • Communication may be difficult!
28
Q

Hypomania vs mania

A
29
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • ….+ manic episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • ….+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
30
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • 1+ manic episode
    • (With or without major depressive episode?)
  • BPAD Type II:
    • 1+ hypomanic episode
    • (with or without major depressive episode?)
    • (NO episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
31
Q

DSM-V criteria - BPAD

  • BPAD Type I:
    • 1+ … episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ … episode
      • 1 major depressive episode
    • (NO episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
32
Q

DSM-V criteria - BPAD

  • BPAD Type …:
    • 1+ manic episode
    • (With or without major depressive episode)
  • BPAD Type …:
    • 1+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
A
  • BPAD Type I:
    • 1+ manic episode
    • (With or without major depressive episode)
  • BPAD Type II:
    • 1+ hypomanic episode
      • 1 major depressive episode
    • (NO episodes of mania)
33
Q

ICD-10 - BPAD

A
  • •2+ episodes
  • •Manic
  • •Hypomanic
  • •Major depressive
34
Q

BPAD II

  • Which gender more prevalent?
  • More difficult to Diagnose
    • Needs more careful history
    • … symptoms may not be spontaneously reported
    • May need collateral
  • Important to Dx:
    • … alcohol, substance misuse
    • ^frequency and severity of depressive episodes
    • May need different treatment – … …
    • BPAD II can progress to BPAD I
A
  • F >M
  • More difficult to Diagnose
    • Needs more careful history
    • Hypomanic symptoms may not be spontaneously reported
    • May need collateral
  • Important to Dx:
    • Increased alcohol, substance misuse
    • ^frequency and severity of depressive episodes
    • May need different treatment – mood stabilisers
    • BPAD II can progress to BPAD I
35
Q

BPAD II

  • Which gender more prevalent?
  • More difficult to Diagnose
    • Needs more careful history
    • … symptoms may not be spontaneously reported
    • May need collateral
  • Important to Dx:
    • … alcohol, substance misuse
    • ^frequency and severity of … episodes
    • May need different treatment – … …
    • BPAD II can progress to BPAD I
A
  • F >M
  • More difficult to Diagnose
    • Needs more careful history
    • Hypomanic symptoms may not be spontaneously reported
    • May need collateral
  • Important to Dx:
    • Increased alcohol, substance misuse
    • ^frequency and severity of depressive episodes
    • May need different treatment – mood stabilisers
    • BPAD II can progress to BPAD I
36
Q

Subtypes of BPAD

  • Rapid cycling BPAD
    • ….+ episodes in single year
    • … prognosis
  • Cyclothymia
    • Chronic, >2 years
    • Periods of mild elation and depression
A
  • Rapid cycling BPAD
    • 4+ episodes in single year
    • Poor prognosis
  • Cyclothymia
    • Chronic, >2 years
    • Periods of mild elation and depression
37
Q

Subtypes of BPAD

  • Rapid cycling BPAD
    • ….+ episodes in single year
    • … prognosis
  • Cyclothymia
    • Chronic, >… years
    • Periods of mild … and …
A
  • Rapid cycling BPAD
    • 4+ episodes in single year
    • Poor prognosis
  • Cyclothymia
    • Chronic, >2 years
    • Periods of mild elation and depression
38
Q

What is rapid cycling BPAD?

A
  • 4+ episodes in single year
  • Poor prognosis
39
Q

What is Cyclothymia?

A
  • Chronic, >2 years
  • Periods of mild elation and depression
40
Q

Differential diagnosis of mania

  • …
    • Secondary to medical condition
      • Eg thyroid disease, MS, brain lesions
      • Delirium
    • Secondary to substance misuse
    • Secondary to medication eg steroids, levodopa
  • …
    • Schizoaffective disorder
    • Schizophrenia
  • …
    • BPAD
    • cyclothymia
  • …
    • EUPD
A
  • Organic
    • Secondary to medical condition
      • Eg thyroid disease, MS, brain lesions
      • Delirium
    • Secondary to substance misuse
    • Secondary to medication eg steroids, levodopa
  • Psychotic
    • Schizoaffective disorder
    • Schizophrenia
  • Affective
    • BPAD
    • cyclothymia
  • Personality
    • EUPD
41
Q

Differential diagnosis of mania

  • Organic
    • … to medical condition
      • Eg thyroid disease, MS, brain lesions
      • Delirium
    • Secondary to … misuse
    • Secondary to … eg steroids, levodopa
  • Psychotic
    • … disorder
    • Schizophrenia
  • Affective
    • …
    • cyclo..
  • Personality
    • E…
A
  • Organic
    • Secondary to medical condition
      • Eg thyroid disease, MS, brain lesions
      • Delirium
    • Secondary to substance misuse
    • Secondary to medication eg steroids, levodopa
  • Psychotic
    • Schizoaffective disorder
    • Schizophrenia
  • Affective
    • BPAD
    • cyclothymia
  • Personality
    • EUPD
42
Q

Treatment of acute manic episodes: General principles

  • Reduce … stimuli
  • Assess for possible contributing substances
    • Recreational/prescribed drugs
    • … … screen
  • Limit potential … behaviour
    • Eg Limit access to cars, bank accounts, credit cards
  • Consider consequences of reckless behaviour
    • Sexual health - emergency contraception/STI screen
A
  • Reduce external stimuli
  • Assess for possible contributing substances
    • Recreational/prescribed drugs
    • Urine drug screen
  • Limit potential reckless behaviour
    • Eg Limit access to cars, bank accounts, credit cards
  • Consider consequences of reckless behaviour
    • Sexual health - emergency contraception/STI screen
43
Q

Treatment of acute manic episodes: General principles

  • Reduce external stimuli
  • Assess for possible contributing substances
    • …/… drugs
    • Urine drug screen
  • Limit potential … behaviour
    • Eg Limit access to cars, bank accounts, credit cards
  • Consider consequences of … behaviour
    • … health - emergency contraception/STI screen
A
  • Reduce external stimuli
  • Assess for possible contributing substances
    • Recreational/prescribed drugs
    • Urine drug screen
  • Limit potential reckless behaviour
    • Eg Limit access to cars, bank accounts, credit cards
  • Consider consequences of reckless behaviour
    • Sexual health - emergency contraception/STI screen
44
Q

Treatment of acute manic episodes

  • STOP any …
  • 1) Antipsychotic- 1 of:
    • O…
    • H…
    • QUETIAPINE
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term benzodiazepine for sedation
A
  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • QUETIAPINE
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term benzodiazepine for sedation
45
Q

Treatment of acute manic episodes

  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • Q…
    • R…
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) … + AP
  • 4) Valproate + AP
  • Short term … for sedation
A
  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • QUETIAPINE
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term benzodiazepine for sedation
46
Q

Treatment of acute manic episodes

  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • H..
    • QUETIAPINE
    • R…
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) … + AP
  • Short term benzodiazepine for …
A
  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • QUETIAPINE
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term benzodiazepine for sedation
47
Q

Treatment of acute manic episodes

  • … any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • Q…
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term … for sedation
A
  • STOP any antidepressant
  • 1) Antipsychotic- 1 of:
    • OLANZAPINE
    • HALOPERIDOL
    • QUETIAPINE
    • RISPERIDONE
      • N.B. NICE guidance – there may be better choices for your individual patient
  • 2) Alternative antipsychotic (AP)
  • 3) Lithium + AP
  • 4) Valproate + AP
  • Short term benzodiazepine for sedation
48
Q

BPAD - If already taking lithium or valproate:

  • Check …
  • … dose
  • .. level?
  • May add …
A
  • Check compliant
  • Optimise dose
  • Li level?
  • May add AP
49
Q

Management – BPAD

  • M… …
  • … antipsychotics
  • E…
  • Psychological – CBT, psychoeducation, psychodynamic, family therapy, relapse prevention
  • Antidepressants? - risk of manic switch
A
  • Mood stabilisers
  • Atypical antipsychotics
  • ECT
  • Psychological – CBT, psychoeducation, psychodynamic, family therapy, relapse prevention
  • Antidepressants? - risk of manic switch
50
Q

Management – BPAD

  • Mood …
  • Atypical …
  • E…
  • Psychological – CBT, psychoeducation, psychodynamic, family therapy, relapse prevention
  • Antidepressants? - risk of … switch
A
  • Mood stabilisers
  • Atypical antipsychotics
  • ECT
  • Psychological – CBT, psychoeducation, psychodynamic, family therapy, relapse prevention
  • Antidepressants? - risk of manic switch
51
Q

Psychiatric history outline in BPAD

A

Psychiatry and Elderly Medicine (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions