Bipolar Disorder

 Bipolar disorder is related to the dysfunction of neurotransmitters such as GABA, serotonin, and norepinephrine.

Characterized by periods of depression with times of mania – irritability, elevated mood, excessive involvement in work or other activities, grandiose ideas, racing thoughts, and a decreased need for sleep.

Patients vary in experiencing mania vs depression; other psychosis often coexist with bipolar disorder.

Drugs for biploar disorder:

Lithium is the primary drug therapy; some anticonvulsants carbamazepine (Tegretol), lamotrigine (Lamictal), and valproic acid (Depakene) are used, but lithium is the drug of choice and is usually prescribed first.

Lithium is a mood stabilizer.

Side effects include nausea, vomiting, dizziness, tremors, fatigue, muscle weakness, a dazed sensation, and increased thirst and urination due to sodium retention; weight gain.

Serious effects include hypothyroidism, heart arrhythmias, and leukocytosis (increase in white blood cells).

• Schizophrenia and Psychosis

• Schizophrenia is related to an imbalance of various neurotransmitters, associated with dopamine and serotonin.

  Schizophrenia is characterized by positive symptoms – hallucinations and delusions – and negative symptoms – withdrawal, ambivalence, behavior changes, memory loss, and confusion. Onset of symptoms is during teenage or early adult years.

  
  

  Drug therapy is necessary to maintain normal thought and function; usually successful in treating positive symptoms but not always completely eliminate negative symptoms.

  
  

  Schizophrenia is one of a variety of psychotic disorders including reactive psychosis – brief, lasting hours to under a month; delusional disorder – delusional, but not illogical thoughts, lasting longer than a month, but do not impair normal function; schizophrenia disorder – similar symptoms to schizophrenia but occurs for less than 6 months.

  Bipolar disorder patients can struggle with thought disorders, hallucinations, or delusions; patients with dementia can exhibit psychotic symptoms; psychosis can be drug induced.

  
  

  Drugs for schizophrenia and Psychosis:

  Drug therapy is individualized and often requires changing therapies over time. Doses are slowly increased to minimize side effects and to achieve a balance between the control of symptoms and side effects.

  
  

  Typical antipsychotics have been available for longer than atypical. Typical antipsychotic side effect profiles are problematic and dose-limiting. Patients are usually given atypical antipsychotics first.