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Bipolar disorder is characterized by pathologic variations in mood, with periods of mania, hypomania, psychosis, and depression.
Conducting a mental status examination (MSE) is also an essential component of evaluating mental health.
Prior to beginning treatment, patients should be clinically assessed for their safety and presenting symptoms.
Treatment of elevated mood syndromes is based upon what has been established for bipolar I disorder, even though bipolar II disorder is more prevalent. Many drugs are effective as monotherapy for treating acute mania, mixed states, and moderate-to-severe hypomania. If the patient experiences rapid cycling, the individual should be evaluated for underlying conditions, such as alcohol abuse or hypothyroidism, which may contribute to cycling.10 Certain medications, particularly antidepressants, may also precipitate cycling and should be tapered down.
Lithium has been around for several decades and is approved by the FDA for treatment of mania and for treatment and prophylaxis of bipolar disorder. Valproate and Divalproex: Valproate has demonstrated efficacy for bipolar disorder in several clinical trials,20 with an FDA indication for acute manic episodes.
Dosing and Monitoring: The starting dose is 750 mg daily in divided doses, and should be titrated upward to desired clinical effect. Side Effects: Common side effects include weight gain, vomiting, hair loss, easy bruising, and tremor. Dosing and Monitoring: The starting dose of carbamazepine is 100 to 200 mg once or twice daily, which should be increased by 200 mg per day every 1 to 4 days. Side Effects: Side effects include nausea, vomiting, diarrhea, hyponatremia, rash, pruritus, leukopenia, fluid retention, and neurotoxicity, which may manifest as drowsiness, dizziness, and changes in vision, lethargy, and headache.
The biggest concern with the use of atypical antipsychotics is their tendency to cause metabolic syndrome, which is characterized by weight gain, glucose intolerance, diabetes mellitus, and hyperlipidemia.1 Metabolic syndrome is more pronounced with olanzapine, risperidone, and quetiapine when compared with aripiprazole and ziprasidone. Few studies have shown promise for use of antidepressants in managing depressive symptoms in bipolar II disorder. The pharmacist plays a tremendous role in optimizing care for patients with bipolar II disorder. As an easily accessible resource, community pharmacists are also key players in providing optimal care to patients with bipolar II disorder. Bipolar II disorder is characterized by hypomanic episodes alternating with major depressive episodes without mania or psychosis. As the UK's fastest growing health directory, we have over 25,000 therapists listed (and counting). Quickly and easily find your nearest complementary therapy or alternative medicine practitioner in London or across the UK. If you are unable to find a therapist or practitioner near enough to you then don't hesitate to call our team on 0800 044 3664 and we will check our records and see if we can suggest a nearer practitioner.
Natural Health Products: weight loss products, herbal remedies, skin care products, mineral vitamins supplements, books, dvds, cds, fitness massage exercise equipment. Towards the bottom of every page there is a 'Recommended Therapies' section which suggests complementary therapies and alternative medicine modalities which may be able to help with a solution to the ailment or problem.

Alternative medicine health articles for the complementary therapy, integrative medicine and natural health sector. Bipolar disorder patients who receive group psychotherapy may be able to reduce their risk of hospital admissions for mood related episodes, according to the latest research from the US.
Psychotherapy is an alternative medicine, complementary therapy and natural health method that can help with a variety of mental health problems.
Psychotherapy helps bipolar sufferers by helping them to recognise when their behaviour and thinking has become disorganised and teach them ways to cope with the illness through improved communication and better stability to their daily routine. In this latest study, researchers set about identifying the effects of different forms of psychotherapy on the condition. Those receiving individual family therapy had any number of sessions determined by the patient with one psychotherapist and a family member present. Over a period of 28 months, 5% of patients receiving multiple group family therapy were hospitalised due to mood episodes compared to 31% in individual family therapy and 38% who received no psychotherapy.
The research team have suggested that group psychotherapy may offer significant advantages for bipolar disorder patients in preventing hospital admission for mood episodes. We always advise with any conditions, ailment or health problem you take independent medical advice from your GP before considering a complementrary therapy, alternative medicine or alternative treatment. The two most common types, bipolar I and bipolar II, differ in the presentation of mood variations. Patients who present with acute manic episodes should be assessed for their risk of suicide, aggressiveness, and potential for violence to others.1 Antidepressants, nicotine, and alcohol should be discontinued, and any substance abuse issues addressed.
First-line medications include aripiprazole, carbamazepine, haloperidol, lithium, quetiapine, olanzapine, risperidone, valproate or divalproex, and ziprasidone.
The first-line pharmacologic treatment for bipolar depression is either lithium or lamotrigine, or, as an alternative for more severely ill patients, lithium can be given with an antidepressant.10 If patients on treatment suffer a breakthrough depressive episode, the dose of the therapy should be optimized before adding other agents. Anticonvulsants that are used in bipolar disorder include valproate or divalproex, lamotrigine, and carbamazepine.
To clinical pharmacists, obtaining an accurate and complete medication history is very important in determining the appropriate therapy, or even identifying underlying medication-related causes of disease cycling.
Not all institutions employ the services of a pharmacist for discharge counseling, and in this instance outpatient counseling through community pharmacists is very important in increasing medication compliance and adherence.
It is less debilitating than bipolar I disorder, yet it still has significant morbidity and mortality if left untreated. Information for healthcare professionals: risk of neural tube birth defects following prenatal exposure to valproate.
You may wish to train to become a therapist, further your education in complementary therapies, or become a natural health practitioner. We do this by marketing each and every practitioner or therapy centre individually providing a marketing campaign that delivers value for money and covers its cost.
Psychotherapy has also been effective in reducing bipolar disorder patients reliance on medication to control their condition. 92 bipolar patients living with a partner or having contact with a significant other continued to take medication during the study. Multi group family therapy involved multiple bipolar disorder patients, their families and two psychotherapists for six sessions.

Fortunately, the majority of patients return to a normal functional level between episodes, yet 15% of patients continue to experience mood lability between episodes.4 Some evidence has shown that sleep-wake cycle disturbances can precipitate or exacerbate a hypomanic or depressive episode.
Lithium levels should be checked 5 days after dosages are adjusted—once the drug reaches steady state concentration. The optimal dose is 800 to 1,000 mg per day in divided doses.18,31 Caution should be exercised when using carbamazepine with other medications metabolized via the CYP450 system, as it may induce the metabolism of other drugs as well as its own metabolism.
The pharmacist can be a viable component in providing appropriate dosing strategies, reviewing therapeutic regimens for drug interactions, instituting clinical monitoring parameters, and identifying signs and symptoms of medication toxicity.
Pharmacological interventions for acute bipolar mania: a systematic review of randomized placebo-controlled trials. Second-generation antipsychotic agents in the treatment of acute mania: a systematic review and meta-analysis of randomized controlled trials. Atypical antipsychotics in the treatment of mania: a meta-analysis of randomized, placebo-controlled trials. Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: a systematic review of randomized trials. Long-term lithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials. Preliminary randomized, double-blind, placebo-controlled trial of pramipexole added to mood stabilizers for treatment-resistant bipolar depression. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. A single blind comparison of lithium and lamotrigine for the treatment of bipolar II depression.
Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009. Efficacy and mood conversion rate of short-term fluoxetine monotherapy of bipolar II major depressive episode. Efficacy and safety of long-term fluoxetine versus lithium mono-therapy of bipolar II disorder: a randomized, double-blind, placebo-substitution study. Participants were then given either individual family therapy, multifamily group therapy or no psychotherapy. If a patient experiences a manic episode, an episode of psychosis, or a mixed episode, the diagnosis changes to bipolar I disorder. Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group.

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