The document outlines treatment guidelines for bipolar disorder, beginning with initiating lithium, divalproex, aripiprazole, or a two-drug combination for patients not currently on medication or first-line medications. It then provides recommendations for augmenting or switching treatment based on a patient's response, including considering second-line, third-line, experimental, or ECT options if a patient does not respond adequately to first-line treatments. The guidelines list specific drug options for mono- and adjunctive therapy at different stages of treatment.
New updates in the concept and clinical usage of "mood stabilizers" based on the new report of WPA section on pharmacopsychiatry, June 2012.
http://1.usa.gov/LrRd3E
Slides from a presentation on a new MRCPsych Course for the East Midlands launching in August 2013 by @arun_chopra, Consultant Psychiatrist, Nottingham
This is a short presentation which gives a definition of self-harm, then looks at why people self-harm including the self-harm cycle. It looks at who can be affected and what might trigger them then tells you some signs to look out for, how to respond if someone tells you about their self-harm and gives some ideas which are useful during recovery.
This presentation can be used just for information or as part of a brief training session.
New updates in the concept and clinical usage of "mood stabilizers" based on the new report of WPA section on pharmacopsychiatry, June 2012.
http://1.usa.gov/LrRd3E
Slides from a presentation on a new MRCPsych Course for the East Midlands launching in August 2013 by @arun_chopra, Consultant Psychiatrist, Nottingham
This is a short presentation which gives a definition of self-harm, then looks at why people self-harm including the self-harm cycle. It looks at who can be affected and what might trigger them then tells you some signs to look out for, how to respond if someone tells you about their self-harm and gives some ideas which are useful during recovery.
This presentation can be used just for information or as part of a brief training session.
6. Establishment
Not on
medication or
first-line
medications
Initiate Li, DVP,
AAP, or 2-drug
combination
On first-
line agent
Lithium
or
DVP
Add or
switch to
AAP
AAP
Add or switch
to Li or DVP
Replace one or both
agents with other first-
line agents
2ND DRUG
COMBINATION (Li
or DVP + AAP)
Replace one or both agents
with other
first-line agents
Consider adding or
switching to second or
third-line agent or ECT
Consider adding novel
or experimental agent
7. • MONOTHERAPY:
LITHIUM,
DIVALPROEX,
DIVALPROEX ER,
OLANZAPINEB,
RISPERIDONE,
QUETIAPINE,
QUETIAPINE XR,
ARIPIPRAZOLE,
ZIPRASIDONE,
ASENAPINE ,
PALIPERIDONE ER
• ADJUNCTIVE
THERAPY WITH
LITHIUM OR
DIVALPROEX:
RISPERIDONE,
QUETIAPINE,
OLANZAPINE,
ARIPIPRAZOLE,
ASENAPINE
• MONOTHERAPY
:
CARBAMAZEPI
N,
CARBAMAZEPI
NE ER, ECT,
HALOPERIDOL
• COMBINATION
THERAPY:
LITHIUM +
DIVALPROEX
• MONOTHERAPY:
CHLORPROMAZI
NE, CLOZAPINE,
OXCARBAZEPINE
, TAMOXIFEN,
CARIPRAZINE
(NOT YET
COMMERCIALLY
AVAILABLE)
• COMBINATION
THERAPY:
LITHIUM OR
DIVALPROEX +
HALOPERIDOL,
LITHIUM +
CARBAMAZEPIN
E, ADJUNCTIVE
TAMOXIFEN
• MONOTHERAP
Y:
GABAPENTIN,
TOPIRAMATE,
LAMOTRIGINE,
VERAPAMIL,
TIAGABINE
• COMBINATION
THERAPY:
RISPERIDONE +
CARBAMAZEPI
NE,
OLANZAPINE +
CARBAMAZEPI
NE
NB:Olanzapine:
Given the
metabolic side
effects, use should
be carefully
monitored.
