Bipolar Flashcards
What are the symptoms of bipolar?
Episodes of extreme highs and lows that can last for several weeks
Mania - feeling of self-importance, hallucinations, happy, lack of eating or increased appetite, lack of sleep, irritable and agitated
Depression - lack of sleep, illogical thoughts, feeling low, lethargy
Hypomania - talking fast, wearing unusual outfits, racing ideas, difficulty concentrating and spending money they do not have, increased libido
What is bipolar 1?
One manic episode needed for diagnosis
Can also have major depressive episodes
What is bipolar 2?
One or more major depressive episodes and one hypomanic episode
But no evidence of mania
What should be done in the annual physical health check?
Weight, diet, nutritional status and level of physical activity
CV status - pulse and blood pressure
Metabolic status, including - fasting blood glucose or HbA1c, and lipid profile
Liver function
Renal and thyroid function,
Calcium levels, for people taking long‑term lithium
What should be included in the crisis plan?
Triggers that the patient has identified
Coping mechanisms
Who to contact if in crisis
What are drugs that can cause mania?
Party drugs
Antibiotics - gentamicin and ciprofloxacin
Steroids
Chloroquine
What should you do if someone is taking an antidepressant?
Consider stopping the antidepressant
Start the antipsychotics
If the first antipsychotic is not tolerated what are next steps?
if maximum dose is used or there is rapid weight gain then switch to another antipsychotic
If that does not work then use lithium
What age is sodium valproate not recommended for?
Males and females under 55, unless agreed by 2 specialists for a high risk:benefit ratio
What should be done if a person is already taking prophylactic mood stabiliser?
Maximise the dose and move onto antipsychotics
If someone develops moderate or severe bipolar depression and is not taking a drug to treat bipolar, what is the treatment?
Offer fluoxetine combined with olanzapine, or quetiapine
