Bipolar Disorder

Although this comes as no surprise to me, there is now clear evidence that lithium is the most efficacious single agent for managing bipolar mania and bipolar depression. If, for whatever reason, lithium is not effective as monotherapy, combining Depakote with it does increase efficacy – although not markedly. The lithium/Depakote combination therefore is optimal in the treatment of bipolar mania. It is becoming increasingly more evident that traditional antidepressants (cyclics, SSRIs, SNRIs, Atypicals) have little, if any advantage, in [...]

The seven classic symptoms of mania and hypomania are probably best summed up through the use of the acronym D I G F A S T Distractibility: Inability to maintain focus on tasks Insomnia: Reduced need for sleep accompanied by increased energy in spite of little sleep Grandiosity: Inflated self-esteem Flight of ideas: Racing thoughts Activities: Increase in goal-directed activity – work, social, school Speech: Excessive, circumstantial, tangential chatter, pressure to keep talking or more talkative than usual Thoughtlessness: Risky [...]

One of the most significant challenges I face as a pharmatherapist is getting my bipolar clients to continue taking their medications as prescribed. More often than not, the culprit driving inconsistent usage patterns is the thrilling and invigorating manic "high." The manic phase of bipolar disorder carries a peculiar treatment challenge that most other mental disorders do not: Because mania is a desirable and enjoyable state for many, if not most patients, medication noncompliance is a particular hazard during these [...]

There's little doubt that the diagnosis of childhood-onset bipolar disorder is on the rise. Office visits by children diagnosed with bipolar disorder multiplied 40-fold from 1994-2003. Disagreements abound as to what this means. Some researchers view the trend as a sign of progress: A disorder that has long gone undiagnosed in children is now being better screened and treated. Others, however, are more skeptical; they perceive the trend to be an example of gross over-diagnosis. In truth, bipolar disorder is [...]