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Flashcards in Bipolar - Chan Deck (12):

What is the Kraepelinian Triad for Mania?

  • Elation
  • Flight of ideas
  • Increased psychomotor activity


Name (7) distinct features that may present in a manic episode. How many of them are required for a diagnosis?

  • Gradiosity
  • Decreased need for sleep
  • Hyperverbal or pressured speech
  • Flight of ideas or racing thoughts
  • Distractibility
  • Increased goal-directed activity, psychomotor agitation
  • More pleasureable activity with painful consequences

3 are needed to make a diagnosis, 4 if the patient is irritable


Describe Stage I Mania

  • Increased psychomotor activity
  • Increased rate of speech
  • Labile, euphoric mood
  • Expansiveness and gradiosity
  • Increased sexual preoccupation, religiousness, spending, letter-writing

Generally "high", but not out of control


Describe Stage II Mania

  • Increased pressured speech and psychmotor activity
  • Increased dysphoria, depression
  • Open hostility and anger
  • Explosive, possibly assaultive behavior
  • Flight of ideas
  • Proccupations with frank delusions


Describe Stage III Mania

  • Desperate, panic-stricken state
  • Frenzied and bizarre psychomotor activity
  • Loose associations
  • Bizarre, idiosyncratic delusions
  • Hallucinations
  • Disorientation
  • Ideas of reference (wiki: phenomenon of experiencing everyday occurrances or coincidences as somehow having strong personal significance - i.e. destiny)


In addition to Lithium, what four other broad drug categories might be helpful in treatment of bipolar disorder?

  • Anti-seizure
  • Neuroleptics (antipsychotics)
  • Antidepressants
  • Omega-3 Fatty acids


Give (5) anti-seizure meds that might be useful in the treatment of bipolar disorder

  • Carbamazepine
  • Valproate
  • Lamictal
  • Clonazepam
  • Gabapentin


Give (6) anti-psychotic meds that may be useful in the treatment of bipolar disorder

  • Aripiprazole
  • Chlorpromazine
  • Olanzapine
  • Quetiapine
  • Risperidone
  • Ziprasidone


Lithium and Carbamazepine have nasty side-effect profiles and several newer drugs are readily available. What's one big reason these are still extensively used?


Lithium ($0.17/pill) and carbamazepine ($0.59/pill) are crazy-cheap compared to newer alternatives (several $ per pill)


What is a hypomanic episode?

Similar to a manic episode, except the mood disturbance is not significant enough to cause marked impairment in social and/or occupational functioning. No psychotic features are present. The episode lasts at least 4 days.


Compare Bipolar I to Bipolar II

Bipolar I

  • presence of at least 1 manic episode
  • With or without hypomanic or depressive episode

Bipolar II

  • Presence of hypomanic and depressive episodes
  • Mood and functioning usually returns to normal between episodes
  • Relatively high suicide risk


What is cyclothymic disorder?

A milder form of bipolar disorder lasting at least two years

Features: hypomania and dysthymia