Treatment of choice for rapid cycles in Bipolar disorder?
Ans. is 'c' i.e., Valproate Treatment of bipolar disorders a. Treatment of acute episodes : - It depends on the type of episode, i.e., manic (acute mania) or depression : - Treatment of Acute Mania : - The treatment of acute mania or hypomania is the easiest phases of bipolar disorders to treat. Drugs used for the treatment of acute mania are: Lithium Valproate Carbamazepine, Oxcarbazepine Atypical & typical antipsychotics : - Olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, Haloperidol, Chlorpromazine. Benzodiazepines : - Clonazepam or Lorazepam can be used as adjunctive treatment for agitation, aggression, insomnia. Treatment of acute bipolar depression : - Antidepressants with a mood stabilizer is used as using antidepressant alone in depressive episode of bipolar disorder can precipitate manic or hypomanic episode. If patient does not respond to standard antidepressants lamotrigine or ziprasidone can be used. b. Maintenance treatment : - It is used to prevent the recurrence after acute episode has been controlled, i.e., Prophylactic treatment for bipolar disorder. Three drugs are commonly used : - Lithium (drug of choice) Carbamazepine Valproate, other drugs which can be used are topiramate and Gabapentin. c. Treatment of rapid cycling :- Valproate is the drug of choice. Other drugs used are Carbamazepine, Lithium, Lamotrigine.
Lithium
Olanzapine
Valproate
Fluoxetine