Bipolar disorders Flashcards
what things can be included in the presentation of pressured speech
puns, jokes, rhymes, or plays on words
what are common misdiagnoses for mania in adolescents
conduct disorder
schizophrenia
9 possible mania symptoms in adolescents
psychosis
substance use
suicide attempts
academic problems
philosophical brooding
OCD symptoms
multiple somatic complaints
marked irritability causing fights
antisocial behavior
when are multiple manic episodes considered distinct
when they are separated by at least 2 months
what is considered rapid cycling
at least 4 mood episodes in a year
cyclothymia
period of at least 2 years of hypomanic and depressive episodes that cause clinically significant distress but do not meet full criteria for bipolar disorder
what is hypomania frequently confused with
borderline personality disorder
poor prognosis predictors for bipolar disorder
poor ocupational status
alcohol dependence
psychotic features
depressive features
male gender
better prognosis predictors in bipolar disorder
short duration of mania
advanced age at onset
few suicidal thoughts
fewer comorbidities
what are the most common psychological deficits in bipolar disorder
executive function
verbal memory/reasoning
bipolar with seasonal pattern
may have winter depression or spring mania
anticonvulsants typically used for bipolar
lamotrigine
carbamazepine
valproate
therapeutic lithium levels
0.6-1.2
medication classes used to treat acute mania
lithium
anticonvulsants
antipsychotics
medication classes for treatment of acute bipolar depression
anticonvulsants
antipsychotics
antidepressants
ECT
Lithium
which anticonvulsant is most frequently used for bipolar depression
lamotrigine
which medications are highly associated with mania induction
TCAs
MAOIs
venlafaxine
therapy options for treating bipolar
CBT
interpersonal
social rhythm
family
mood episode commonality between the sexes
depressive episodes more common in women
manic episodes more common in men
therapeutic blood level for depakote
50-120
first line anticonvulsant treatment for acute mania in bipolar
valproate and carbamazepine
lamotrigine in bipolar
better at treating bipolar depression than mania
what is valproate approved for in bipolar
acute mania, not maintenance
important thing to remember about starting lamotrigine
must be titrated slowly to avoid rash
which antipsychotic has the best evidence for treatment of acute bipolar depression
seroquel
administration of antidepressants in bipolar
needs to be in conjunction with mood stabilizer to avoid induction of mania
most widely used agents for long term treatment of bipolar
lithium
valproate
carbamazepine
what is often required with long term lithium treatment
thyroid supplementation
what to do for first-line treatment failures
try another first-line treatment option
goals for therapy with bipolar disorder
improving treatment adherence
promoting stability
avoiding risk factors
what inflammatory markers are typically elevated in bipolar patients
interleukin-6
response inhibition
executive function that allows one to control impulsive responses when they might be inappropriate
