Bipolar - Chan Flashcards
What is the Kraepelinian Triad for Mania?
- Elation
- Flight of ideas
- Increased psychomotor activity
Name (7) distinct features that may present in a manic episode. How many of them are required for a diagnosis?
- Gradiosity
- Decreased need for sleep
- Hyperverbal or pressured speech
- Flight of ideas or racing thoughts
- Distractibility
- Increased goal-directed activity, psychomotor agitation
- More pleasureable activity with painful consequences
3 are needed to make a diagnosis, 4 if the patient is irritable
Describe Stage I Mania
- Increased psychomotor activity
- Increased rate of speech
- Labile, euphoric mood
- Expansiveness and gradiosity
- Increased sexual preoccupation, religiousness, spending, letter-writing
Generally “high”, but not out of control
Describe Stage II Mania
- Increased pressured speech and psychmotor activity
- Increased dysphoria, depression
- Open hostility and anger
- Explosive, possibly assaultive behavior
- Flight of ideas
- Proccupations with frank delusions
Describe Stage III Mania
- Desperate, panic-stricken state
- Frenzied and bizarre psychomotor activity
- Loose associations
- Bizarre, idiosyncratic delusions
- Hallucinations
- Disorientation
- Ideas of reference (wiki: phenomenon of experiencing everyday occurrances or coincidences as somehow having strong personal significance - i.e. destiny)
In addition to Lithium, what four other broad drug categories might be helpful in treatment of bipolar disorder?
- Anti-seizure
- Neuroleptics (antipsychotics)
- Antidepressants
- Omega-3 Fatty acids
Give (5) anti-seizure meds that might be useful in the treatment of bipolar disorder
- Carbamazepine
- Valproate
- Lamictal
- Clonazepam
- Gabapentin
Give (6) anti-psychotic meds that may be useful in the treatment of bipolar disorder
- Aripiprazole
- Chlorpromazine
- Olanzapine
- Quetiapine
- Risperidone
- Ziprasidone
Lithium and Carbamazepine have nasty side-effect profiles and several newer drugs are readily available. What’s one big reason these are still extensively used?
$$$
Lithium ($0.17/pill) and carbamazepine ($0.59/pill) are crazy-cheap compared to newer alternatives (several $ per pill)
What is a hypomanic episode?
Similar to a manic episode, except the mood disturbance is not significant enough to cause marked impairment in social and/or occupational functioning. No psychotic features are present. The episode lasts at least 4 days.
Compare Bipolar I to Bipolar II
Bipolar I
- presence of at least 1 manic episode
- With or without hypomanic or depressive episode
Bipolar II
- Presence of hypomanic and depressive episodes
- Mood and functioning usually returns to normal between episodes
- Relatively high suicide risk
What is cyclothymic disorder?
A milder form of bipolar disorder lasting at least two years
Features: hypomania and dysthymia
