Bipolar Disorder: Treatment

cannot be cured; instead, the emphasis of treatment is on effective management of and prevention of further episodes by use of pharmacological and .

Hospitalization may occur, especially with . This can be voluntary or (if mental health legislation allows it) involuntary (called civil or involuntary commitment). Long-term inpatient stays are now less common due to deinstitutionalization, although can still occur.[67] Following (or in lieu of) a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or Assertive Community Treatment team, supported employment and patient-led support groups.[68]

Medication

The mainstay of treatment is a ; these comprise several unrelated compounds which have been shown to be effective in preventing relapses of manic, or in the one case, . The first known and “gold standard” mood stabilizer is lithium,[69] while almost as widely used is ,[70] originally used as an anticonvulsant. Other anticonvulsants used in include carbamazepine, reportedly more effective in , and , which is the first one to be shown to be of benefit in depression.[71]

Treatment of the agitation in acute has often required the use of antipsychotic medications, such as , and Chlorpromazine. More recently, and have been approved as effective monotherapy for the maintenance of .[72] A head-to-head randomized control trial in 2005 has also shown monotherapy to be as effective and safe as lithium in prophylaxis.[73]

The use of antidepressants in has been debated, with some studies reporting a worse outcome with their use triggering manic, or mixed episodes, especially if no is used. However, most mood stabilizers are of limited effectiveness in .

Related posts

June 7, 2008 | Filed Under Mental Disorders 

Comments

Leave a Reply