Bipolar disorder Flashcards
Types of bipolar disorder?
Type 1 - mania and depression.
Type 2 - Hypomania and depressionD
Definitions of mania and hypomania?
Mania - Abnormally elevated mood/irritibility with severe functional impairment of psychotic symptoms > 7 days.
Hypomania - Abnormally elevated mood/iritibility with decreased or increased for 4+ days.
Main differentiation - Psychotic symptoms and whether it has significant impact on functioning.
Management of bipolar disorder?
Lithium - mood stabilizer of choice, can use valproate.
Mania/hypomania - consider stopping antidepressant and start antipsychotics.
Depression - Fluoxetine is antidepressant of choice. Talking therapy.
Address co-morbidities - higher risl of diabetes, CV disease
What is cyclothymia?
Milder symptoms of hypomania and low mood. Symptoms not severe enough to significantly impair function
What is unipolar depression?
Only has episodes of depression without mania or hypomania.
What is the management of an acute episode of bipolar?
Acute manic episdoe: First line - Antipsychotic medications. Others - lithium or valproate.
Acute depressive episode: Olanzapine plus fluoxetine, antipsychotic meds or lamotrigine.
Referrals required for bipolar disorder?
If symptoms suggest hypomania - routine referral to community mental health team.
If symptoms suggest mania or severe depression - urgent referral to community mental health team