Bipolar Disorder

Question 1

What is bipolar disorder?

Answer 1

A serious long term chronic condition where you have lows (periods of depression) and highs (periods of mania or hypomania (less severe symptoms)

Question 2

What are the symptoms of bipolar disorder

Answer 2

Patients will have 3 or 4 of the following:
- grand ideas about yourself and yourself
- increased energy and less sleep
- more talkative than usual
- full of new ideas and plans. Often the plans are grandiose and unrealistic
- irritation and agitation
- wanting to do lots of things, things that please you most ie. Excess shopping, alcohol and drugs)

• hypomania (high but not as severe)

Question 3

Symptoms of depression in bipolar

Answer 3

• low mood for most of the day, nearly everyday
• loss of enjoyment and interest in life , even for activities that you normally enjoy
• abnormal sadness, often with Weepiess
• feeeling guilty, worthless or useless
• poor motivation- even simple tasks seem difficult
• poor concentration- it may be difficult to read,work etc.
• sleep problems

Question 4

What medication is used to treat bipolar?

Answer 4

• Benzodiazipines
• Antipsychotics
• Carbamazepines
• Valporate
• Lithium v

Question 5

Mania nd hypomania Drug

Answer 5

Antimanci drugs are used to control acute attacks and prevent recurrent episodes of mania or hypomania
- continue long term treatment of bipolar for at least 2 years from last manic episode and up to 5 years if the patient has risk factors of relapse

• give antidepressants for depression (avoid in patients with rapid cycling bipolar disorder, recent history of hypomania or rapid mood fluctuations

Question 6

Benzodiazipines eg, Lorazepam

Answer 6

• For agitation or behavioural disturbance
• avoid long term use (may cause dependence)

Question 7

Antipsychotics

Answer 7

• give olanzapine, quetiapine or Risperidone for mania and hypomania
• if response is inadequate then add lithium or Valporate

Question 8

Carbamazepine

Answer 8

Used for prophylaxis of bipolar disorder, manic depressive disorder

Used in patients with rapid cycling manic depressive illness ( 4 or more effective episodes per year)

Question 9

Valporate

Answer 9

Used to treat and for prophylaxis of manic episodes
Avoid in women of child bearing potential

Question 10

Lithium salts

Answer 10

Used in prophylaxis and treatment of mania,hypomania and depression in bipolar disorder (manic depressive disorder)
Used to treat aggressive or self harming behaviour
- two forms lithium citrate and lithium carb