Rx Note

Introduction Bipolar disorder is characterized by recurrent episodes of elevated or irritable mood and depression , accompanied by changes in sleep and energy and associated with cognitive, physical and behavioural symptoms. Bipolar I disorder is characterized by at least 1 episode of mania , and usually episodes of depression and/or hypomania. Bipolar II disorder is characterized by a history of major depressive episodes and hypomanic episodes only, without episodes of mania. Bipolar disorder has a strong genetic basis and a peak onset in young people . Management Consider mood stabilizers (e.g. lithium or valproate) and second-generation antipsychotics (e.g. quetiapine, lurasidone, aripiprazole, olanzapine, risperidone) for the primary treatment of bipolar disorder. For maintenance treatment of bipolar disorder, aim for the highest tolerable lithium plasma level in the range of 0.6-0.8 mmol/L. Reduce to 0.4-0.6 mmol/L in case of good response but poor tolerance, or Increase to 0.8...