The Pharmacological Treatment of

Bipolar disorder

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 Classification of Bipolar Disorders

Rapid cycling Bipolar Disorder

Bipolar I Bipolar II Bipolar Not Otherwise
disorder Specified

One or more One or more Four episodes Bipolar features

manic or mixed major depressive manic, hypomanic that do not meet
episodes, usually episodes mixed or criteria for any
accompanied by accompanied depressive specific bipolar
major depressive by at least one episodes. disorders
episodes hypomanic
episode
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* Symptoms do not meet criteria for manic and depressive episodes.

First, ed. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Rev.
Washington, DC: American Psychiatric Association; 2000:345-428.
 Bipolar Disorder
Ø
ØIs an illness that effect human brains
by causing a serious shifts in an
individuals moods.
ØApproximately 2.6% of American
populations are effected by bipolar
disorder.
ØProminent cognitive abnormalities

http :// www . helpguide . org / mental / bipolar_disorder_symptoms_treatment . htmDate

http :// www . tourettesyndrome . net / Files / NIMH_bipolar_overview2002 . pdf page 3 date
excess 10 / 03 / 2009 DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES
OF HEALTH .
 Causes of Bipolar disorder


ØGenetics factors: Highly heritable

(80%genetic contribution).
ØEnvironmental factors: there is a clear
evidence that people when firstly
experienced the illness is belonging to a
significant changes in their life.


http :// herkules . oulu . fi / isbn9514267672 / html / i43346 . html Date excess to it
1 / 4 / 2009 5
 Bipolar Disorder- Neurobiology


ØUnbalance in certain chemicals called

neurotransmitters which has an
essentials rule in sending messages to
the next nerve cells that involves
controlling emotions and movements.
ØStructural and functional brain
abnormalities: _amygdale, anterior
cingulated and prefrontal cortex,
putamen, thalamus/hypothalamus


Cognitive Dysfunction in Bipolar Disorder Rumana Chowdhury , I . NicolFerrier ,

Jill Maria Thompson Published : 01 / 22 / 2003
2Strakowski SM, et al. Expert Opin. Pharmacother. 2003;4:751-760.
 Symptoms of Bipolar Disorders

Depression or
Mania ( manic Mixed episode
Hypomania major
episode) symptoms
depressive
The individuals Is a milder form of The depression In this episode
will be excessively mania , the patient symptoms will be both symptoms of
energetic, easily will experience characterizing by depression and
distracted, talking elevating of moods sadness, mania will be
very fast, creative and creativity. worthlessness, low occurring.
and showing self esteem and
aggressive suicidal thoughts.
behavior.

http://www.helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm
Treatment Challenges in Bipolar Disorder

Often unrecognized
Often untreated
Often misdiagnosed
Often inadequately treated
Exacerbated by incorrect
treatment


Akiskal. J Clin Psychopharmacol. 1996;16(suppl 1):4S-14S.

Lithium
 Uses
 acute and prophylactic treatment of mania /
hypomania
 acute and prophylactic treatment of bipolar
depression
 Side effect
 Dry mouth
 Feeling of weakness
 has a negative influence on kidney function and
thyroid gland


Divalproex

 Uses

-Euphoric, mixed episode and rapid cycling
episodes.
Side effects

- sedation, tremor, weight gain also is
causing liver inflammation and effecting
production of platelets.

Novel drugs

Tamoxifen
 Uses in treating cancers
 especially breast cancers
show a great effectiveness
 in reducing manic symptoms.
Interfere with hormones such as
oestrogen.
Anti depressants drugs
Ø In bipolar disorder anti-depressants drugs are
used to relieve the depression symptoms.
Ø examples are monoamine oxidise inhibitors
MAOIs, Selective serotonin reuptake
inhibitors SSRIs and heterocyclic.
Anti - Psychotics Drugs
Ø Used in bipolar disorder to treat psychotics
symptoms .
Ø Example : olanazapiene

- used in treating manic and mixed episode.

- Side effect: weight gain, dry mouth and
elevated blood liver function.
Summary
Ø Bipolar disorder is a mental illness that
causes changing in individuals mood, the
symptoms are manic, major depressive and
mixed episode.
Ø There are different types of bipolar disorder,
bipolar disorder 1, bipolar disorder 2 and
rapid cycling.
Ø The treatment of bipolar disorder could be
achieved by prescribing mood stabilizers
drugs, type of mood stabilizers drugs
included lithium, depakate and many
more.