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Bipolar management


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  • 1. BIPOLAR DISORDER Management
  • 2. Management • Bipolar disorder is a complex and chronic illness. • It produces major shifts in mood and energy. • It impairs all areas of a person’s life, including work, relationships and daily functioning. • Fortunately, however, effective treatment exists, and you can get better. • The goal of treatment is not to cure the disorder but rather to control the symptoms and the course of the disorder.
  • 3. Hospitalization The indications for inpatient treatment in a person with bipolar disorder include the following: • Danger to self • Danger to others • Total inability to function • Total loss of control
  • 4. Pharmacotherapy Treatment for bipolar disorder can be divided into 3 general categories: Acute treatment: focuses on suppressing current symptoms Continuation treatment: Prevents a return of symptoms during the same maniac or depressive episode Maintenance treatment: Prevents a recurrence of symptoms
  • 5. PROGNOSIS GOOD PROGNOSIS • Length of manic phases (short in duration) • Late age of onset • Few thoughts of suicide • Few psychotic symptoms • Few medical problems • Family H/O bipolar disorder BAD PROGNOSIS • Poor job history • Substance abuse • Psychotic features • Depressive features between periods of mania and depression • H/O attempts to end life • Male sex
  • 6. Categories of drugs used • Mood Stabilizers • Anti-psychotics • Anti-depressants • Anti-convulsants • COMBINATION DRUGS Symbax : Antidepressant fluoxetine + Antipsychotic olanzapine
  • 7. It’s a balancing act!
  • 8. LITHIUM • Preparations:  Lithium carbonate  Lithium citrate  Lithium sulphate
  • 9. Mechanism of Action • The most widely accepted hypothesis is: • Inhibition the enzyme inositol monophosphatase, lead ing to higher levels of inositol triphosphate.
  • 10. Adverse drug reactions • Most common side effect: Fine tremors • Nausea & headache • Dehydration and electrolyte imbalance • Lithium induced diabetes insipidus and hypothyroidism • LITHIUM is a TERATOGEN(Ebstein’s anomaly) • The risks of long-term medication use must be weighed against the risk of relapse.
  • 11. Psychotherapy • Behavioral therapy. This focuses on behaviors that decrease stress. • Cognitive therapy. This type of approach involves learning to identify and modify the patterns of thinking that accompany mood shifts. • Interpersonal therapy. This involvesrelationships and aims to reduce strains that the illness may place upon them. • Social rhythm therapy. This helps you develop and maintain daily routines.
  • 12. Support Groups Better understanding of the illness, share their concerns, and learn how to best manage them Receive encouragement, learn coping skills, and share concerns • Patient feels less isolated as a result • Family members and friends may also benefit from a support group