Bipolar Disorder

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Pharmacologic Treatment of Bipolar Depression

In bipolar disorder, depression is often the neglected stepchild. Mania gets more attention, perhaps because it presents so dramatically. Imagine two bipolar patients in an emergency room: one withdrawn and depressed, sitting quietly, and another ranting and pacing the room. Which one would be seen first?

Discussing Bipolar Disorder with Your Patients

In my experience, there are five common reactions from patients with a new diagnosis of bipolar disorder, and here are some suggestions for how to respond constructively.

Using Lithium in Bipolar Disorder: A Primer [Subscribers Only]

Currently, lithium is FDA approved for both acute mania and for maintenance bipolar treatment, but not for bipolar depression. Lithium is dirt-cheap and the size of its database for efficacy in bipolar disorder is unmatched by any other medication, although many of these studies are old.

Research Update

Mood Stabilizer plus Antidepressant May Protect Against Mania

Most of you would hesitate to put a patient with bipolar I on antidepressants without adding a mood stabilizer, in order to prevent a switch to mania. If this is your clinical practice, you are following the recommendations of the APA consensus guidelines for the treatment of bipolar depression. But the hard data to support the danger of switching is surprisingly weak.

Maternal Flu and Risk of Bipolar Disorder

Several past studies have investigated a possible link between infections during pregnancy and psychiatric illness in the offspring. These studies may be biased, however, by poor recall or by a clinical, as opposed to serological, diagnosis of infection in the mother. A recent study attempted to overcome this bias by measuring influenza antibodies—a more precise manner of identifying influenza exposure—drawn from the mothers of bipolar offspring.

Expert QA

Distinguishing Bipolar from Unipolar Depression

Some patients complain bitterly about depression and dysphoria, but they don’t tell you anything about the other half of their lives—the upswings of mood and energy—so you may not realize the need to suspect bipolar illness.

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Pharmacologic Treatment of Bipolar Depression [Free Article]

Bipolar Disorder - The Carlat Psychiatry Report (TCPR)

In bipolar disorder, depression is often the neglected stepchild. Mania gets more attention, perhaps because it presents so dramatically. Imagine two bipolar patients in an emergency room: one withdrawn and depressed, sitting quietly, and another ranting and pacing the room. Which one would be seen first?