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Bipolar affective disorder (incidence (1-2%, onset 20's, M=F),…
Bipolar affective disorder
definition
episodic disturbance with interspersed periods of depressed and elevated mood (hypomania or mania)
class I: >1 manic >1 depressive
class II: depressive>manic
aetiology
genetic
Life events
physical illness
sleep deprivation
medication
incidence
1-2%
onset 20's
M=F
?pathophysiology
Diagnosis
clear evidence of episodes of depression and mania
psychosis possible
treatment
depression
#
SSRIs
psychological
ECT
mood-stabiliser
lithium
acute mania
adjuvant for Rx resistant depression
prophylaxis 1st line
sodium valporate
prophylaxis 2nd line
anti-psychotics
olanzapine
prophylaxis 2nd line
quetiapine
risperidone
prognosis
high relapse rate (10-15%)
chronic
Complications
drugs
weight gain
teratogenic
hypothyroidism
incr Ca PTH
diabetes insipidus
disease
suicide