CLINICAL FEATURES AND MANAGEMENT OF MANIC-DEPRESSIVE DISORDER

Question 1

___________ disorder formally referred to as manic- depressive disorder is a mood disorder characterized by episode of ______________ and ___________________.

Answer 1

Bipolar

major depression

mania or hypomania.

Question 2

CLASSIFICATION OF BD
Bipolar I : _______________ + _______________
Bipolar II : _______________ + _______________
Bipolar III : _______________
Bipolar IV : _______________ induced manic/hypomanic episode
Bipolar V : _______________ disorder with a _______________
Bipolar VI : ? _______________ Mania

Answer 2

Bipolar I : Major depression + Mania
Bipolar II : Major Depression + Hypomania
Bipolar III : Cyclothymia
Bipolar IV : Antidepressant induced manic/hypomanic episode
Bipolar V : Major depressive disorder with a family hx of BAD
Bipolar VI : ?Unipolar Mania

Question 3

Clinical features

Manic episode:
Persistently _____________ mood
Increased _________ , overactivity,
pressure of _______ and decrease ___________
Loss of _____________ may result in reckless and out of character behavior
Maybe accompanied by ____________, or extreme ___________________

Answer 3

elevated or irritable

energy; speech; need for sleep

social inhibitions

delusion ; flight of ideas

Question 4

Clinical features

Depressive episode:
___________ mood
__________ energy/ ________ energy
Diminished capacity for _———,———-, and —————
________ or ________ feeling
Disturbed sleep and fatigue
Diminished ___________ or increased

Answer 4

Depressed

Reduced; decreased

enjoyment, interest and concentration

Guilt or worthless

appetite

Question 5

Clinical features

Mixed affective episode—_________ episode:

Mixed or _________________ of ________ and _________ symptoms
Persistent _________ of mood
_____eased energy and activity
______eased sociability, talkativeness, over-familiarity
_____eased sexual energy and a _____ease need for sleep

Answer 5

Hypomanic

Rapid alteration; manic and depressive

mild elevation; Incr; Incr; Incr; decr

Question 6

BD MANAGEMENT

Bipolar Mania.
Mild – Moderate severe acute Mania.
(a)___________ Monotherapy with ——— or Divalproex.
(b) Or _______________ such as ____________.

Answer 6

Mood stabilizer (MS); Lithium

atypical antipsychotic (AAP); olanzapine

Question 7

BD MANAGEMENT

Bipolar Mania.
Severe cases, or mixed episodes:
_________________ .
(APs or AAPs?) are preferred to (APs or AAPs?).

Answer 7

MS + AAP

AAPs; APs

Question 8

BD MANAGEMENT

Bipolar Mania.

An alternative to Valproic acid is _____________, especially in ___________ and rapid cycling.

Answer 8

Carbamazepine

mixed mania

Question 9

BD MANAGEMENT

Bipolar Mania.
Patients spend a disproportionately greater amount of time in ________ states than in ______________ states.

Answer 9

depressed states

Manic or hypomanic states.

Question 10

Which is more difficult to manage

Bipolar mania or unipolar depression

Answer 10

Bipolar mania Treatment is more difficult than in unipolar depression.

Question 11

In BD MANAGEMENT

____________________ has a high risk for rapid cycling or a cycle of response and relapse.

Answer 11

Antidepressant monotherapy

Question 12

In BD MANAGEMENT

Bipolar depression
Recommended approach (first line) is the use of a __________ or _______________ . Researchers disagree as to the possibility of adding antidepressants even in severe depression.

Answer 12

MS or lamotrigene

Question 13

In BD MANAGEMENT

Is there any gain in using antidepressants as adjunct? Answer – ____________

Answer 13

Both yes and no

Question 14

In BD MANAGEMENT

Bipolar depression

AAP monotherapy (_________) has also been tried.
The only available FDA approved medication is _______________________________________

Answer 14

olanzapine
Olanzapine – Fluoxetine combination (OFC).