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Interview family members and treat bipolar depression

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1. interview family members or other persons providing information

There are several reasons why we should try to ask wife, parents, child, “the other special people” or

friends of the patient. The patient cannot remember the symptoms of mania or hypomania or does not

wise to know the impact of symptoms on his activities. In other words, many patients evaluate that they

can control their activities in hypomania episodes and does not think they are disease. Many patients

may feel disgrace when having bipolar disorder. Therefore, interview several people close to the

patients may provide a history for an accurate diagnosis.

2.This treatment of patients with bipolar depression

Although the statement true bipolar depression often in the hands of the primary care physician,

referral or check psychiatrist should be considered a positive in the treatment of these patients.

Pharmaceutical therapy of bipolar disorder are more at risk than in major depression (unipolar). In

addition, multi‐therapeutic principle in many patients; only 20.6% of patients with bipolar disorder was

used as monotherapy.


Discuss chemotherapy of bipolar disorder outside the scope of this article, however, some keywords will

be talking about. Lithium is the standard drug treatment for bipolar disorder for decades. In recent

years, the presence of multiple antiepileptic drugs is characterized by mood stabilizers, among which

include divalproex,


Coordinate Olanzapine ‐ Fluoxetine is approved recently treated depressive phase of

bipolar disorder; This combination effectively described in 8‐week study, randomized, controlled, double

blind bipolar depressed patients.

Carbamazepine and lamotrigine as well as increased awareness of using antipsychotics such as

olanzapine, an atypical, risperidone, quetiapine and ziprasidone were enhanced treatment of bipolar

disorder physicians.


Although no manic idiopathic factors in this study, the risk of developing mania associated with the use

of fluoxetine would need to be fully evaluated. Lithium, olanzapine and Lamotrigine is FDA approved for

the maintenance treatment; Lamotrigine is approved for use in the maintenance treatment of bipolar

disorder I.


The appearance of many new drug treatment of bipolar disorder is understood that the drug may

choose not only effective but also tolerance. Lithium has a number of side effects, low‐threshold

treatment and risk of fatal overdose; however it is the only drug reduced the risk of suicide in patients

with bipolar disorder. Divalproex used in manic episodes than in depressive episode; accompanied by

weight gain, tremor, hepatotoxicity and drug interactions; Carbamazepine though never FDA approved

treatment of bipolar disorder, has been studied and shown to be effective, but requires checking drug

concentration / serum and risk reduction Na + blood and confusion created blood. Lamotrigine is

described effective in bipolar depression and prevention of relapse of depression in patients with

bipolar disorder, to increase the dose slowly and carefully checked to avoid the possibility of erythema

but does not require blood count test and together with light weight, sexual side effects, drowsiness or

cognitive impairment.


Olanzapine, Quetiapine, Risperidone and some other antipsychotics with moving disorders include

weight gain, increased risk of diabetes and increased triglycerides, sometimes accompanied by

inflammation of the pancreas. Therefore, screening of patients is required when these drugs are used

long term, according to the American Diabetes Association / American Psychiatric Association, the

Committee agreed on antipsychotic drugs and obesity.



Treatment of antidepressants in patients with bipolar disorder have its own difficulties. Although the

treatment of antidepressant monotherapy in user manuals are now treating bipolar disorder using

antidepressants necessary in some patients. Instructions American Psychiatric Association now

recommends using Bupropion and Paroxetine is an antidepressant top. However, this is only the

antidepressant was evaluated for the treatment of bipolar disorder in the randomized controlled

demonstrate that describes a relatively low risk of switching to mania; Therefore, the conclusion can not

be regarded as superior to the other antidepressants in the treatment of bipolar disorder. In general,

clinicians agree that antidepressants inhibit the reuptake of serotonin in SSRI sertraline as effective and

safe and monoamine oxidase inhibitors also relatively rarely switch to mania.


The other reason is taken to a mental examination of patients with bipolar disorder can cause various

diseases, with progression, clinical manifestations difficult to predict depressive feelings chart carefully

assess mental and often requires particularly apparent illness each patient and give the optimal

treatment. Games substance abuse power with high and difficult treatment and increased non‐

adherence to treatment and prognosis.


Finally, the influence of social psychology at the importance of bipolar disorder. The divorce rate higher

than 2‐3 times higher than the general population and the majority of people are experiencing

difficulties in occupational, social, and long to be part dinhkeo psychosocial intervention. All these issues

are resolved in a mental environment more suitable.

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