Bipolar Disorders

Flashcards covering key concepts and vocabulary related to Bipolar Disorders, including definitions and explanations of important terms.

Bipolar I Disorder

Characterized by at least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes.

Mania

A period of abnormally elevated mood and increased activity lasting at least one week.

Hypomania

A milder form of mania, lasting at least four days with symptoms similar to mania but less severe.

Cyclothymic disorder

A chronic mood disorder involving numerous periods of hypomanic symptoms and periods of depressive symptoms that do not meet the criteria for a major depressive episode.

Inflated self-esteem or grandiosity

An elevated sense of self-worth often seen in manic episodes.

Epidemiology

The study of how often diseases occur in different groups of people and why.

Comorbidity

The presence of one or more additional disorders co-occurring with a primary disorder.

Psychomotor agitation

Excessive and unintentional movements that are often initiated by anxiety, which can occur during manic episodes.

Lithium

A medication used to treat mood disorders, particularly bipolar disorder, known for its narrow therapeutic range.

Therapeutic Relationship

The professional relationship between a caregiver and a patient aimed at fostering healing and improvement.

Recovery-Oriented Care

An approach to mental health care that emphasizes collaboration and supports individuals in their recovery journey.

Antipsychotics

Medications used to manage psychosis, mood stabilization in bipolar disorder, and other psychiatric conditions.

Bipolar I Disorder

Characterized by at least one manic episode, which may be preceded or followed by hypomanic or major depressive episodes.

Bipolar II Disorder

Characterized by at least one major depressive episode and at least one hypomanic episode without a full manic episode.

Cyclothymic Disorder

A chronic mood disorder involving numerous periods of hypomanic symptoms and periods of depressive symptoms that do not meet the criteria for a major depressive episode.

Signs of Mania

Increased energy, reduced need for sleep, inflated self-esteem or grandiosity, and impulsive behavior.

Signs of Depression in Bipolar Disorder

Feelings of sadness, loss of interest in activities, changes in appetite, sleep disturbances, and difficulty concentrating.

Treatment for Bipolar Disorder

Includes a combination of medication, psychotherapy, lifestyle changes, and support groups.

Common Medications for Bipolar Disorder

Lithium, mood stabilizers (like valproate), and antipsychotics (like quetiapine). Each has its own side effects.

Common Side Effects of Lithium

Nausea, tremors, increased thirst, and the need for regular blood tests due to its narrow therapeutic range.

Common Side Effects of Antipsychotics

Weight gain, sedation, and risk of metabolic syndrome.

Psychotherapy for Bipolar Disorder

Cognitive Behavioral Therapy (CBT) and Psychoeducation are effective approaches to manage symptoms.

Recovery-Oriented Care

An approach that emphasizes collaboration and supports individuals in their recovery journey.

Therapeutic Range for Lithium

0.6-1.2 MEQ/L for maintenance.

Moderate Toxicity of Lithium

Confusion, dysarthria, nystagmus, myoclonic twitches, ECG changes.

Severe Toxicity of Lithium

Life-threatening, grossly impaired consciousness, increased deep tendon reflexes, seizures, syncope, renal insufficiency, coma, death.

Action for Moderate or Severe Toxicity Symptoms

Withhold additional doses of lithium, notify the provider, obtain lithium level, push fluids.

Divalproex Sodium (Valproic Acid) (Depakote)

An anticonvulsant used to treat mania, mixed mania, rapid cycling, and secondary mania.

Monitoring for Divalproex Sodium

Baseline and q6 months CBC with differential and liver function tests are required. Divalproex levels are monitored weekly until therapeutic, then q6 months.

Therapeutic Range for Divalproex Sodium

50 to 120 ng/mL.

Signs and Symptoms of Toxicity for Divalproex Sodium

Dizziness, agitation, stupor, disorientation, tachycardia, hypo or hypertension, nausea and vomiting, coma, shock, respiratory depression, nystagmus, and neuromuscular disturbances.

Black Box Warning for Divalproex Sodium

There is a black box warning for hepatotoxicity, highlighting the risk of liver damage when using this medication.

Carbamazepine

An anticonvulsant that also has mood stabilizing effects, commonly used in the treatment of bipolar disorder.

Monitoring for Carbamazepine

Baseline, months 1 and 3, and yearly CBC with differential and liver function tests are required.

Carbamazepine Level Monitoring

Carbamazepine levels are monitored monthly until therapeutic effect is achieved.

Therapeutic Range for Carbamazepine

8 to 12 ng/mL.

Signs and Symptoms of Toxicity for Carbamazepine

Dizziness, agitation, stupor, disorientation, tachycardia, hypo or hypertension, nausea and vomiting, coma, shock, respiratory depression, nystagmus, and neuromuscular disturbances.

Black Box Warning for Carbamazepine

There is a black box warning for aplastic anemia and agranulocytosis, highlighting significant risks associated with its use.

Lamotrigine

A medication used during depressive episodes and approved for maintenance treatment of bipolar depression, requiring slow dose titration.

Risk of Stevens-Johnson Syndrome with Lamotrigine

Lamotrigine carries the risk of Stevens-Johnson syndrome, which is a serious skin reaction.

Monitoring for Rash

Always assess for any rashes when administering Lamotrigine, as this could indicate the onset of Stevens-Johnson syndrome.

Patient Education for Lamotrigine

Patients should be informed about the importance of slow titration of the dose, potential side effects including skin reactions, and the necessity of contacting their healthcare provider if a rash develops.