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Psych 3.6

QuestionAnswer
Criteria for mania Intensive mood disturbance that lasts at least 1 week for most of the day, everyday. Alternates with depression or a mixed state of anxiety and depression
Bipolar 1 Disorder Most severe, highest mortality rate of the three, atleast 1 manic episode
Bipolar 2 disorder Atleast 1 hypomanic episode, atleast 1 major depressive episode.
Cyclothymic Disorder Hypomania alternate with symptoms of mild to moderate depression for atleast 2 years in adults, 1 year in children
Mania digfast Distractibility, impulsivity, grandiosity, flight of ideas, activity increase, sleep deficit, talkativeness.
Mania in BP1 flow chart Utter exhaustion after mania, depression, extreme behaviors such as violence or attempted suicide
Hypomania in BP2 A low level less dramatic mania, euphoric and increases functioning, and accompanied by excessive activity and energy
What are the risk factors for BP? If one twin has the disorder, 60% chance the other will too.
What is BP1 genetically correlated with? Schizophrenia
What is BP2 genetically correlated with MDD
What is replaced in BP? An overactive and critical superego is replaced with euphoria.
Altman's self rating mania scale Scores of 6 or higher suggest mania or hypomania and the need for treatmne.t
What is sufficient sleep in bpd? 4-6 hours
What is the most effective tool for a patient experiencing mania Distractibility
What are support group sources Depression and Bipolar support alliance, and National alliance on mental illness
What are the drugs for severe agitation Lithium divalproex, risperidone
Lithium Onset 10-21 days
Lithium therapeutic range for maintenance and for acute mania Acute mania - 1.0-1.2 mEq/L Maintenance - 0.6-0.8 mEq/L
Toxic levels of lithium >1.5mEq/L, can cause N/V/D, polyuria, ataxia, seizures, and death.
How are lithium labs scheduled? 2-3 days at the beginning of therapy and after any dosage change, then 3-6 months at maintenance.
Contraindications to lithium Less than 12 years old, pregnancy, breast feeding, and renal or thyroid disease
What should you avoid with lithium? Caffeine, have a consistent sodium diet, and adequate fluid intake. Hold med for dehydration.
 

 



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