Mood Disorders

What are the four mood episodes

Manic

Hypomanic

Depression

Mixed

Mania

The symptom state (elevated mood)

Bipolar I

Manic or Mixed Episode + MDD

Bipolar II

MDD and Hypomania episodes

Mixed epiodes patients have…

Earlier age onset

more frquent hospitalizations

What are some predictors of mortality in Bipolar

Male

Psychotic features

mixed episode

residual symptoms

What is the inital goal of mood disorder treatment?

Provide rapid symptom releif

What is the ultimate goal of treating mood disorders

Relapse prevention

If full mania is present at any time, what diagnostic do they recieve?

Bipolar I

If there is only hypomania + depression, what diagnostic?

Bipolar II

What state do Bipolar patients spend 3x more time in

Depressed state

Lithium treats

Acute mania, Bipolar, maintenance

What are two problems of lithium?

Narrow therapeutic window

Plasma levels monitored

Why do patients stop taking lithium

Nonadherance means they miss the highs and feeling its been solves.

What is Lithiums mechanism

Intracellular signalling and neuroprotection

What are the Lithium side effects

Dose related - lithium toxicity, memory and cog, weight gain, reduced energy

What is lithiums timing

1-3 weeks for therapeutic effects

What anticonvulsant is this?

Valporate

What does valporate treat

Acute mania

Mixed episodes

rapid cycling bipolar disorder

What is the best treatment when resistent to lithium?

Valporate

Valporate timing and SE’s

a few days, polycystic ovaries in women and weight gain

What are the three anticonvulsants

Valporate

Lamotrigine

Carbamazepine

What is Lamotrigine poorly effective in treating?

Acute mania

What is the drug of choice for bioplar depression patients

Lamotrigine

Lamotrigine mechanism

Voltage gated chanel blocker

What anticonvulsant has a benign rash SE?

Lamotrigine

What does Carbamazepine do best?

Reduce episode frequency

What is Carbamazepine used for?

Mixed and rapid cycling

What are traditional antipsychotics considered effective in treating?

Mania

What are traditional antipyschotics limited by?

Neuroleptic effectsd (EPSP’s)

When treating Bipolar disorder the final goal is

prevent relapse