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Outline
History of Bipolar Disorder Symptoms of Bipolar Disorder Diagnosis of Bipolar Disorder Treatment of Bipolar Disorder Future of Bipolar Disorder
Subdivided
Bipolar I - one or more manic or mixed episodes with or without depressive episode Bipolar II - one or more Major Depressive Episodes along with at least one Hypomanic episode Cyclothymia - one or more Hypomanic episodes and Dysthymic (chronic depression) episodes
Brain scans indicating the differences in brain activity when a patient is switching between a depressive episode and hypomanic episode
Brain scans showing the increased amount of brain matter with the use of lithium utilizing the growth promoter called brain-derived neurotrophic factor
Treatments
Medications:
Mood stabilizers - Lithium (Lithobid, Lithane, Eskalith, ect.) Anticonvulsants - Depakote, Tegretol Bipolar Depression - Lamotrigine Antipsychotic - Seroquel, Zyprexa, Risperdal, ect. Antidepressants are questionable due to the fact that some believe that it induces a manic episode especially if there is no mood stabilizers used.
Hospitalization
May occur, especially with manic episodes. This can be voluntary or involuntary. Long-term inpatient stays are now less common due to deinstitutionalization, although can still occur. Following a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or Assertive Community Treatment team, supported employment and patient-led support groups.
Eskalith
Preclinical studies have shown that lithium alters sodium transport in nerve and muscle cells and effects a shift toward intraneuronal metabolism of catecholamines, but the specific biochemical mechanism of lithium action in mania is unknown. Indicated in the treatment of manic episodes of manic-depressive illness. Maintenance therapy prevents or diminishes the intensity of subsequent episodes in those Bipolar patients with a history of mania. Fine hand tremor, polyuria, and mild thirst may occur during initial therapy for the acute manic phase, and may persist throughout treatment. Transient and mild nausea and general discomfort may also appear during the first few days of lithium administration.These side effects usually subside with continued treatment or a temporary reduction or cessation of dosage. If persistent, cessation of lithium therapy may be required. Diarrhea, vomiting, drowsiness, muscular weakness, and lack of coordination may be early signs of lithium intoxication, and can occur at lithium levels below 2.0 mEq/L Because lithium theraputic levels are so close to the toxic levels lithium concentration levels must be monitored constantly and before treatment is given
Depakote
Dissociates to the valproate ion in the gastrointestinal tract. The mechanisms by which valproate exerts its therapeutic effects have not been established. It has been suggested that its activity in epilepsy is related to increased brain concentrations of gamma-aminobutyric acid (GABA). Depakote ER (divalproex sodium extended-release) is indicated for the treatment of acute manic or mixed episodes associated with bipolar disorder, with or without psychotic features Side Effects: Fever, sore throat, body aches, diarrhea, tremors, ect.
Lamotrigine
Lamotrigine tablets are indicated for the maintenance treatment of Bipolar I Disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes) in patients treated for acute mood episodes with standard therapy. If used in conjunction with valproate (Depakote) the dosing should be cut in half due to the absorption rate in its presence. Side effects: Dizziness, headache, blurred or double vision, nausea, vomiting, rash, ect.
Seroquel
Used in the treatment of both depressive episodes and acute manic episodes associated with Bipolar I disorder It has been proposed that the efficacy of Seroquel in its mood stabilizing properties in bipolar depression and mania are mediated through a combination of dopamine type 2 (D2) and serotonin type 2 (5HT2) antagonism. Antagonism at receptors other than dopamine and 5HT2 with similar receptor affinities may explain some of the other effects of Seroquel.
Tardive Dyskinesia - A syndrome of potentially irreversible, involuntary, dyskinetic movements may develop in patients treated with antipsychotic drugs. Chronic antipsychotic treatment should generally be reserved for patients who appear to suffer from a chronic illness that (1) is known to respond to antipsychotic drugs, and (2) for whom alternative, equally effective drugs have no effect
Future of Disorder
It has been discovered that lithium protects neurons by increasing the levels of a neuroprotective protein called Bcl-2. Lithium has been found to help stimulate the production of new neurons (neurogenesis) in the hippocampus part of the limbic system that control emotions and behavior. A major breakthrough came in 2000, with the demonstration that lithium increases the amount of gray matter in the human brain, probably by stimulating the production of a growth promoter called brain-derived neurotrophic factor When the researchers compared the brains of bipolar patients on lithium with those of people without the disorder and those of bipolar patients not on lithium, they found that the volume of gray matter in the brains of those on lithium was as much as 15 percent higher in the cingulate and paralimbic regions of the brain, that are critical for attention, motivation and emotional control.
Works Cited
www.drugs.com www.wikipedia.org www.wrongdiagnosis.com www.helpguide.org http://richardgpettymd.blogs.com/my_weblog/neurotoxicity