Mood Disorders

SSRI/SNRI Dosing Schedule for Bipolar Depression

No dose increases before $4\text{--}6\,\text{weeks}$ on current dose in order to maintain the lowest effective dose with least risk.

Suicide Ideation Impulsivity and Firearm Removal

In the US, $50\%$ of individuals attempt suicide within $10\,\text{minutes}$ of ideation, making firearm removal critical. Because $90\%$ of attempt survivors do not die by suicide, restoring firearms later is possible.

Depakote Reproductive Risks and Counseling

Depakote use in women of childbearing age with a history of a child with neural tube defects (NTD) is indefensible. For men on Depakote, the chance of having a child with a neurodevelopmental disorder is $1.5 \times$ higher ($2\%$ absolute risk), which requires counseling.

Bipolar 1 Dementia Risk and Lithium Protective Effect

Individuals with bipolar 1 disorder have a $300\%$ higher risk of developing dementia. Lithium reduces the chance of dementia by $49\%$ in the bipolar population.