Mania

2,196 views

Published on

brief description on mania

Published in: Education, Health & Medicine
0 Comments
5 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,196
On SlideShare
0
From Embeds
0
Number of Embeds
8
Actions
Shares
0
Downloads
209
Comments
0
Likes
5
Embeds 0
No embeds

No notes for slide

Mania

  1. 1. MANIA Dr Madhura.T.K.
  2. 2.  Definition: Distinct period during which there is abnormally persisting elevated, expansive or irritable mood.Mood disorders – syndrome, with cluster of signs & symptoms
  3. 3. Common underlying characteristics• Elevated mood• Increase in quantity & speed of physical & mental activity
  4. 4. Clinical featuresMOOD:Elevated, feels on the top of the worldFeeling of intense well beingIrritability, outbursts of unprovoked anger:
  5. 5. IMPAIRMENTS IN (N) FUNCTIONING: Excess energy, tiredness & exhaustion Over activity: ^ level of motor activity actions – hurried & clumpsy Conduct & behavior: lot of attention colorful clothes, lack of social inhibition- abrasive, over familiar & outspoken, reckless spending of money
  6. 6. Cont….. Bodily sym. ^ appetite decreased need for sleep ^sexual need
  7. 7.  IMPACT ON PSYCHOLOGICAL FUNCTIONS: Thinking: Acceleration of speed Flight of ideas Flowery language DD: schizophrenia, Delusions : Grandiose Persecutory
  8. 8. 4 subtypes by ICD-10, Hypomania Mania without psychotic symptoms Mania with psychotic symptoms Manic episodes, unspecified
  9. 9. 1.Hypomania:Lesser degree of maniaSymptoms as that of mania, but never leads to disruption of work or social rejectionDiagnostic guide lines: ^ mood & ^ activity- several daysConsiderable interference with work/ social activity is consistent with hypomania.DD: Hyperthyroidism Anorexia nervosa Agitated depression Severe obsessional symptoms
  10. 10. 2.Mania without psychotic symptoms^mood, uncontrollable excitement with ^energy overactivity pressure of speech decreased need for sleep loss of social inhibitions unsustained attention marked distractibility grandiosity
  11. 11. Cont…. Perceptual ideas: appreciation of color Preoccupation with fine details of surfaces Subjective hyperacusis Mood : irritable & suspiciousFirst attack: 15- 30 yrsDiagnostic guide lines: sym – 1wk disruption of ordinary & social activities mood change + ^ energy
  12. 12. 3.Mania with psychotic symptoms Severe form of mania Inflated self esteem, grandiose ideas, delusions, irritability, suspiciousness into delusions of persecution, SEVERE CASES : grandiosity mood: incongruent neutral delusions/hallucinationsDD: schizophrenia4.Maniac episodes , unspecified.
  13. 13. DIAGNOSTIC GUIDELINESICD-10^moodUndue optimismExcessive energyOver activityDecreased need for sleepInflated self esteem, grandiosityExtravagance in spendingPressure of speechEpisode- 1wk, severe enough to disrupt work 7 social activities
  14. 14. DSM-IV Distinct period of abnormality, persistently elevated mood, expansive, irritable Mood disturbance with 3 or more sym Symptom do not meet the criteria for a mixed episode Mood disturbance is sufficiently severe to cause marked impairment in occupational functioning Symptom are not due to direct physiological effects of a substance or general medical condition
  15. 15. TREATMENT Maniac episodes: antipsychotics mood stabiliser olanzapine parenteral antipsychotics
  16. 16. DRUGS LITHIUM:Main stay of Rx – acute mania prophylactic agent600-900mg/day, initiallyTR 0.5- 1mEq/lMonitor for hypothyroidism
  17. 17.  SODIUM VALPROATE: TR 50 – 100 mcg/ml 20mg/day in divided dosesSE: thrombocytopenia ^ transaminase levelsPre Rx: CBC LFT
  18. 18.  CARBAMAZEPINE: 400-600mg/dayTR: 4-12mcg/lSE: SJ syndromePre Rx : CBC LFTEnzyme inducer, lowers blood levels of haloperidol
  19. 19.  LAMOTRIGINE: Adv. Doesn’t require blood level monitoringDose 25mg/day X 2wksIncremental doses, 25mg further
  20. 20.  TOPIRAMATE:Unique feature- wt loss25-50mg/day can be given upto 200-300mg/day
  21. 21. REFERENCES: J.N.Vyas-Essentials of post-graduate psychiatry Namboodri-Concise text book of Psychiatry DSM-IV, Diagnostic manual ICD-10, Diagnostic manual Niraj Ahuja- Concise text book of Psychiatry Eapen- Essentials of Psychiatry
  22. 22. THANKS FOR PATIENT LISTENING!!!!!!!!!

×