Bipolar disorders

Other Conditions Mood disorder or personality dysthymia cyclothymia Grief reaction denial, depression, acceptance Atypical grief Adjustment disorder

Bipolar disorders Definition C/F 1-behavior dress,expression,activity,attitude 2-mood Euphoria, elation, ecstasy, irritability 3- speech Form rapid Content

4- thought Form flight of ideas Content delusion grandiose 5- perception Hallucinations 6-cognition Distractibility Disinhibition, reckless spending 7- insight N/B Sleep appetite Mania and hypomania

Bipolar disorders DDx schizophrenia drug induced states organic conditions Etiology 1- genetic 2- amine theory Raised noradrenaline metabolites Serotonine related mechanism Dopamine 3-psychological Flight into mania

Bipolar disorder Epidemiology Age 30 Prevalence 0.6-1% No women excess Course and prognosis 3-6 months Recurrence 50 % Less mania more depression

Bipolar disorders Management 1- acute phase Mood stabilizers Antipsychotics; haloperidol ECT 2- prophylaxis Lithium; risk of toxicity, teratogenic Close monitoring Physical work up Carbamazepine, valproate lamotrigine Indications of lithium 3 or > 2 years severity prophylaxis in unpopular depression augmentation in resistant depression

Bipolar disorder Bipolar depression unique entity mood stabilizers, lamotrigine