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Bipolar Disorder - Coggle Diagram
Bipolar Disorder
Core Features
Mania
Elevated mood
Insomnia - no need for sleep
Racing thoughts / speech
Persists for weeks
Increased energy
Distractibility
Reckless behaviour
Impaired insight
Depression
Hypomania
Less severe form of mania with minimal functional impairement and some insight
Psychosis in Mania
Rare - 20%
Mood congruent
Delusions
Grandiose
Persecutory
Hallucinations
Auditory
Causes
Genetic inheritance
Role of monoamines (dopamine)
HPA axis distrubance - disordered cortisol
Stress precipitates episodes
Management
Maintenance - Mood Stabiliser
Lithium
⭐
S/E
Polyuria
Polydipsia
Weight gain
Metallic taste
Fine
tremor
Teratogenicity
Toxic Effects
Course
tremor
N/V
Neurological anomalies
Confusion
Myoclonic jerks
Ataxia
Seizures
Stupor
Death
MOA
Unknown
Disadvantages
Low therapeutic range (0.6-1.0 mmol/L)
Treatment of Toxicity
Stop lithium
Fluids
Monitoring
Renal function
Thryoid function
Lithium level
Weight
ECG
Other use
Augment antidepressant efficay
Baseline checks
BMI
ECG
FBC
Pregnancy test
Sodium Valproate
Teratogenic
C/I
Can become pregnancy (woman of childbearing age)
Carbamazepine
Lamotrigine
Manic management
Mood stabiliser
Lithium
Antipsychotic
Olanzapine
Quetiapine
Depression treatment
Mood stabiliser
Lithium
Anti-Depressant Medication
Cyclothymia
Mood fluctuations less severe than bipolar
Intermediate state
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Risks
High rate Deliberate self harm
Suicide - up to 20% longer term
Epidemiology
Young adults
