Bipolar Disorder

Question 1

What is bipolar?

Answer 1

Occurrence of one or more manic episodes usually followed by episodes of major depressive disorder

Question 2

What are the three types of bipolar?

Answer 2

T1- at least one manic or mixed episode
T2 - at least one major depressive episode plus one milder manic syndrome (hypomania)
Cyclothymic - alteration between hypomania and mild depression

Question 3

What are the symptoms of bipolar?

Answer 3

Elevated/irritable mood for equal to or +1wk and at least 4 of below
- distracted
- racing thoughts
- grandiosity
- inc activity
- inc talking
- dec need to sleep
- inappropriate/reckless behaviour

Question 4

What are the key features of bipolar?

Answer 4

Mania
Hypomania
Depression

Question 5

Describe the difference between mania and hypomania

Answer 5

• both elevated, expansive and or irritable mood
• mania has a marked functioning impairment whilst hypomania does not

Question 6

Describe the term rapid cycling

Answer 6

At least 4 episodes in a year

Question 7

Describe the term ‘mixed states’

Answer 7

Manic and depressive features present during the same episode

Question 8

What is the therapeutic range for lithium?

Answer 8

0.6-1.5mmol/L

Question 9

What is lithium indicated for?

Answer 9

Acute mania or prophylaxis of mania

Question 10

What is the dose of lithium

Answer 10

Once nightly (or BD)

Question 11

What are the pharmacokinetics of lithium?

Answer 11

• it peaks 3-5hours in
• takes several days to reach steady state
• it is 100% renally excreted