Ex3 Flashcards
(60 cards)
Bipolar I
Disorder where one has at least one episode of mania
Bipolar II
Major Depressive and hypomanic esisodes. In contrast to BPI there does not need to be a full blown manic episode
Cyclothymia
Less severe form of Bipolar Disorder which has numerous periods of hypmanic symptoms and numerous periods of depressive symptoms
Bipolar, NOS
Not otherwise specified means it does not quite fit the checklist
Symptoms of Mania
Irritability, Excessive High Risk Activity, Inflated Self-Esteem, Flight of ideas, distractibiliyy,decreased need for sleep
Difference between BP induced depression and MDD
The depression associated with BP is one that is briefer in duration, more rapid onset, contain anergia, psychomotor retardation ad reversed vegetative symptoms
Reversed vegetative symptoms
Overeating (hyperphagia) and ovversleep (hypersomnia) … this is in contrast to vegetative symptoms which are insomnia and a loss of appetite
Prevelance of BP I and BP II (W/respect to M F)
Affects around 1% of population, BDI is equally impactful to males and females while BDII appears to impact females more than males
Age of onset of BP
First symptoms around 15-19 while there is a long delay for diagnosis and treatment
Mortality of BP
25-50% attempt suicide wherein 19% succeed (high lethality)
Why is differential diagnosis difficukt?
Not diagnostic test to say wether or not it is BP. BP depression also can look like MDD< antioscoial behavioral disorder, ADHD, conduct disorder or substance induced disorder
Difference between BP and MDD
BP is earlier onset, has more episodes, more familial mania, more equal in sex distribution, HIGHLY heritable,
T/F BP has a high concordance rate among identical twins
TRUE
Mood stabilizers
Potential pharmacologic use for treatment against BP. Similar in nerobiological action to antidepressants
Structural Changes to brain from MDD
Reduction in volume of prefonrtal cortext and hipposcampus, decreases in the number of neurons and glial cells in prefrontal cortext
Chemical Changes to brain from MDD/BD
Lower levels of neurochemical N-acetyl-aspartate
N-acetyl-aspartate
A neurochemical that is often used as a marker for neuronal health. It shows reduced leves in those with MDD and BD
BDNF
Brain derived trophic factor. BDNF is a neurotrophic factor. The use of mood stabilizers is said to reverse impairments toward the level of BDNF in the brain
Neurotrophins
Neurotrophins are proteins that induce the survival, development, function and plasticity of neurons
Rita Levi-Montalcini
A Nobel Prize winning physiologist that discovered the nerve growth factor (NGF) in the brain which causes develpoing cells to grow by stimulating surronding nerve tissue
Four classes of drugs for the treatment of Bipolar disorder
(1) Lithium (2) Anticonvulsant Mood Stabilizers (3) Atypical antipsychotics (4) Omega-3-fatty acids
Why Lithium probably used less than other drugs
Lithium, being an element, is not patentable which means companies cannot make a profit from it so there is little incentive to provide it when there are other drugs that are profitable.
Why was Lithium not super effective
Compliance is poor, side effects are intolerable and people usually miss the highs and the mood swings. The Lithium serves to really placate and calm the mood swings but some can perceive this as boring
Lithum excretion
Lithium is usually excreted unmetabolized. It is less impacted by liver disease as it will just be excreted out and does not need to be broken down by liver enzymes however kidney damage or fluid imbalanence would cause severe problems
