Bipolar II

Clinical Update

How to Diagnose ADHD in Bipolar Disorder

Topics: ADHD | ADHD Rating Scale-5 | Attention Deficit Hyperactivity Disorder | Bipolar Disorder | Bipolar II | Comorbidity | Diagnosis | Diagnostic Testing | Hypomania | Psychiatric interviewing

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many s

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Expert Q&A

Overdiagnosis in Psychiatry

Topics: Adult ADHD | Bipolar II | Borderline Personality Disorder | BPD | Diagnosis | DSM | PTSD | Stigma

TCPR: Which disorders are the most overdiagnosed in psychiatry? Dr. Paris: At the top of the list are major depression, PTSD, bipolar II, adult ADHD, and—this one is a recent addition because it used to be underdiagnosed—borderline personality disorder. Each of these conditions may be underdiagnosed in some settings as well, but they have also been

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Research Update

Maintenance Pharmacotherapy of Bipolar Disorder: How Long Is Long Enough?

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Lithium | Medication adherence | Mood Stabilizers | retention

Review of: Kishi T et al, Psychol Med 2020 Oct 13:1–9; PMID: 33046156 Type of study: Meta-analysis of double-blind, randomized placebo-controlled trials Bipolar disorder is a lifelong illness whose treatment is an ongoing challenge, complicated not least by difficulties in treatment adherence. What do we know and what can we tell our patients about

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Clinical Update

How to Use Lamotrigine

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Borderline Personality Disorder | BPD | Hypomania | Lamictal | Lamotrigine | Medication | Mood Stabilizers | OCD | Pharmacology | Psychopharmacology

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

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Research Update

Mood Stabilizers: What You Don’t Know Can Hurt Them

Topics: Antipsychotics | Aripiprazole | Asenapine | Bipolar Depression | Bipolar Disorder | Bipolar II | Cariprazine | Lithium | Lurasidone | Mania | Medication adherence | Mood Stabilizers | olanzapine | Oxcarbazepine | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips | Quetiapine | Research | Research Update | Risperidone | safety | Saphris | Side Effects

Review of: Bai Y et al, J Clin Psychopharmacol 2020;40(2):167–179 STUDY TYPE: Combined meta-analysis and literature review of placebo-controlled trials Medication adherence is an ongoing struggle in bipolar disorder, and it’s compounded by the fact that our patients often don’t advertise their ­non-adherence. While numbers vary, reviews general

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Expert Q&A

Who Should Get Lithium?

Topics: Bipolar Disorder | Bipolar II | Coronavirus | COVID19 | Lithium | Mania | Mood Stabilizers | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips

TCPR: Lithium has been called the gold-standard treatment in bipolar disorder. Why is it not used more often? Dr. Rybakowski: That is a paradox. On the one hand, lithium is accepted as a first-line treatment for bipolar disorder, but it is also greatly underutilized. And I think there are two main reasons. One is aggressive promotion of branded mood st

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Research Update

A New Antipsychotic for Bipolar Depression

Topics: Antipsychotics | Bipolar Depression | Bipolar Disorder | Bipolar II | Caplyta | Lumateperone | Research Update

Lumateperone (Caplyta) just hit the pharmacy shelves with FDA approval in schizophrenia (see TCPR March 2020), and its manufacturer is pursuing further approval for bipolar depression. So far they’ve completed two phase III trials—one negative and one positive—and the positive one was presented in poster form by Suresh Durgam and colleagues at the

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