bipolar disorder: What are the treatment of acute phases?

Some medications are used to relieve symptoms when they are very severe. Once this goal is achieved , they leave room for DMARDs to prevent relapse. Acute phases of severe bipolar disorder resistant to treatment, the doctor may prescribe ECT ( electroconvulsive therapy ) .

The treatment of acute manic phases

During severe manic attacks, the doctor may use mood stabilizers at higher than those prescribed for treatment of substance, but also sedative neuroleptic doses.

The treatment of acute depressive phases

During a severe depressive phase , the doctor may prescribe antidepressants , especially the family of inhibitors of serotonin reuptake (IRS). However, these drugs should be used with caution, as some of them may promote the emergence of a manic phase .

For this reason , it happens that the first manic episode in a patient known to appear as a result of the prescription of antidepressant treatment . This can happen in patients with depression who have not reported to their doctor that they had experienced periods of abnormal euphoria (ie signs of bipolar disorder ) . This also occurs in patients who have never experienced manic phase and in which these antidepressants have revealed the existence of bipolar disorder hitherto unexpressed .

Thus, when bipolar disorder are not too severe , antidepressants are not used to avoid the risk of causing mania . If the patient can endure a little longer depressive symptoms, the doctor often prefer to wait until the mood stabilizers do their purpose ( in a few days to a few weeks). The effectiveness of mood stabilizers in bipolar disorder will be better in the absence of antidepressants.

How to use mood stabilizing drugs ?

It is essential to note taking mood stabilizers in the new pharmacist and doctor consulted.
In addition , we must be careful not to become dehydrated ( so drink enough ) and do not eat too much or too little salty foods. Thus , living in a hot country require greater monitoring and adaptation of salt intake . It should also be careful not to consume too much diuretic substances such as coffee or tea.

A thorough treatment by a lithium salt is always implemented gradually . The adjustment of the effective dose is achieved through monitoring of lithium levels in the blood. Blood tests are carried out every five days at the beginning of treatment , and are spaced . When treatment is stabilized , these blood tests are done every two to three months. The effectiveness of treatment with lithium salts is evaluated after one to two years . This treatment lasts for several years , even a lifetime .

Drinking alcohol is strongly discouraged with lithium salts . You have to be extremely vigilant about the risk of interaction between lithium salts and other drugs (eg, nonsteroidal anti -inflammatory drugs like ibuprofen or niflumic acid).

Blood tests are also needed in case of treatment with Tegretol and generics . These drugs also interact with many drugs and , in particular, reduce the effectiveness of birth control pills.

If pregnant or breastfeeding

In women treated with mood stabilizers, there are significant risks in pregnancy and it is a priori against inappropriate. If a patient with bipolar disorder are well controlled by medication wants a child, it must first talking with your doctor. Special measures must then necessarily be implemented during pregnancy: possible revaluation of treatment, more frequent monitoring of drug levels in the blood, increased monitoring of fetal development in the relevant imaging centers and additional folic acid intake . Breastfeeding is not recommended in all cases.

When can we stop the background processing?

If the symptoms have disappeared with treatment lasting background, a very graceful shutdown may possibly be considered, but only after several years. The decision is always difficult, and many patients prefer to continue their therapy. When stopping treatment background, the patient and his family must be extremely vigilant to the possible emergence of manic symptoms: sudden feeling of improvement, quarrels with family members, recurrence of tic impulse purchases , decreased sleep, frantic phone calls, etc..

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