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what is delirious mania?
A grave form of the disorder characterized by an intensification of
the symptoms associated with acute mania. The condition is rare
since the advent of antipsychotic medication.
- Labile mood, panic anxiety
- Clouding of consciousness, disorientation
- Frenzied psychomotor activity
- Exhaustion and possibly death without intervention
what is considered a depressive episode?
Same as depression!
- Depressed mood OR Loss of Interest/Pleasure + 5 other symptoms
of depression including the one above
- Must be present for at least two weeks
what does rapid cycling mean?
At least 4 episodes of mood disturbance within 12 months
,what are the treatments for bipolar disorder?
Cognitive therapy
Interpersonal therapy
Group therapy
Family therapy
ECT for Episodes of mania when:
- Client does not tolerate medication.
- Client fails to respond to medication.
- Client's life is threatened by dangerous behavior or exhaustion.
Psychopharmacology:
- For mania: Lithium carbonate, Anticonvulsants, Verapamil,
Antipsychotics
- For depressive phase: Use antidepressants with care (may trigger
mania)
,what is lithium carbonate?
Names: Eskalith caps, Eskalith CR tabs, Lithium carbonate caps &
tabs, Lithobid slow release tabs, Litane, Lithonate, Lithium Citrate
(Lithonate-S)
Uses:
- Treat mania
- Prevention of mania
- Effects Na and K distribution across the cell membranes in CNS
- Normalizes synaptic neurotransmission of NE, SER, DOP
- Abolishes the excitement, euphoria, and insomnia without causing
sedation
- Effective in 80% of clients
Dosing:
- Guided by plasma levels
- For acute mania: 1.0 to 1.5 mEq/L
- For maintenance: 0.6 to 1.2 mEq/L
- Lithium levels should not exceed 1.5mEq/L
Contraindications:
- Cerebrovascular disease
- Renal disease
- Dehydration
- Sodium depletion
- Schizophrenia
- Brain damage
- Pregnancy & Lactation
- Diuretic therapy
- Children under 12
Side effects:
- Drowsiness, Dizziness, headache
- Dry mouth (Thirst)
- GI upset (Nausea and vomiting)
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