Bipolar Long Term Management

Question 1

How often is there recurrence in Bipolar disorder?

Answer 1

Within 2 years of getting people well about half of them will recur

Question 2

What is the gold standard for maintenance treatment in Bipolar disorder?

Answer 2

Lithium

Question 3

Is Lithium better at preventing mania or depression?

Answer 3

Mania

Question 4

What other important benefit does Lithium have?

Answer 4

May prevent suicidal

Question 5

What level is best for Lithium?

Answer 5

Aim for around 0.6, try not to go over 0.8

Question 6

How often should Lithium be dosed?

Answer 6

Once daily at bedtime. No need for ER unless GI discomfort

Question 7

What good combinations with Lithium have been studied?

Answer 7

Lithium and Valproate

Lithium and atypical antipsychotic

Question 8

How long should atypical antipsychotic add-on be continued to prevent recurrence?

Answer 8

At least 6 months

Question 9

What might be a reason to add an antidepressant in Bipolar disorder?

Answer 9

Anxiety comorbidity

Question 10

Which psychosocial interventions are effective in Bipolar?

Answer 10

CBT

Question 11

Why worry about residual symptoms?

Answer 11

Increased recurrence and suicide risk