Handbook of Diagnosis and Treatment of Bipolar Disorders

Handbook of Diagnosis and Treatment of Bipolar Disorders This readable guide to the assessment and management of patients with bipolar disorder can he

bipolar treatment

This readable guide to the assessment and management of patients with bipolar disorder can help physicians keep abreast of dramatic and rapid advances of recent years and integrate them into their practice. Handbook of Diagnosis and Treatment of Bipolar Disorders emphasizes recent controlled studies and U.S. Food and Drug Administration (FDA) approved indications and translates these data into the real world of clinical practice. The contributions of the eleven chapter authors from Stanford University reflect more than a decade of clinical research and treatment undertaken at that institution, including advances in diagnosis and interventions supported by controlled studies. The manual provides crucial information regarding diagnosis, pharmacotherapy, psychotherapy, and treatment of patients from special populations such as children, women, and older adults and patients with particularly challenging illness courses such as rapid cycling.

This is the first book to provide quantitative assessment of potential benefit (number needed to treat) and risk (number needed to harm) for all approved treatments for bipolar disorder, providing clinicians with information needed to balance benefits and risks in order to render individualized state-of-the-art, evidence-based care. The manual describes all FDA-approved therapies reviewing efficacy, safety, tolerability, pharmacokinetics, illness phase specific dosing, and drug interactions and summarizes published therapeutic data, as well as results of randomized controlled clinical trials very recently presented at major scientific conferences.

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Commonly question about Handbook of Diagnosis and Treatment of Bipolar Disorders

Question :

I think I have ADD but I am diagnosed with Bipolar, how can I get my doctor to review my diagnosis?

I read in a book (called ADHD A handbook for Diagnosis and Treatment, 2nd Addition by R. Barkley) that the followings distinctions should be noted:

*the age of onset of ADHD is typically earlier than in BP & that it is quite rare for a child to be diagnosed with BP, which has a typical onset in late teens early adulthood. The onset of my problems was first 8 (when I heard voices although this could have been due to trauma of repeated surgery), then 13 (when I was coincidentally run over by a car and broke my leg). At 13 my behaviour became totally erratic and I lost the ability to focus at school, all my reports from high school say I have great potential if only I would concentrate.

* ADHD has a chronic and pervasive pattern of impairment over time and accross situations. BP tends to be cyclical and episodic with wide mood swings and grandiosity. I have never had grandiosity except for a slight obsession with creating a reformed religion with influences from Quakerism, Alevism, Islam and Zoroastrianism. But I have never seen myself in a grandiose manner. I also do not have mood swings, I have a chronic and persistent inability to focus on tasks even the simplest of tasks I find difficult, and I have chronic and consistent mild Depression with one major episode of Depression. I would say I am Dysthymic rather than full blown Depressed. The book also says that a person with BP is clearly not their normal self when in an episode and exhibits uncharacteristic symptoms, such as engaging in reckless activities, dangerous driving, spending sprees etc... This does not describe my symtoms at all, although I do have an almost omnipresent need to spend money.

* The person with BP has bursts of productivity and accomplishes a great deal in a short amount of time with little sleep. Again, I do not exhibit such symptoms, and am quite unable, infact, to be productive at all.

* The person with BP also has periods of believing they have special powers and exhibits great energy. I do not have such episodes. I actually have very little energy because I am on 1000mg Depakote and 2mg Risperidone (an anti-psychotic, even though I do not have psychotic features!). Prior to medication I was almost consitently hyperactive and would be wide awake every day until day light, then would crash with fatigue and wake up early afternoon. This made me virtually unable to hold a job down and I infact once had 23 days off sick due to fatigue in the space of a 300 day working year. I still experience days like that, though this is normally following a particularly stimulating evening doing something exciting (being excited is something I rarely experience since being on mood stabilisers and anti-psychotics).

* There is an absence of psychotic features and abnormally expansive or elevated mood in ADHD, whereas those features are evident in BP. I did experience hearing voices and once hallucinated around the age of 8, but my psychologist has suggested that this was due to trauma as I had several general anaesthetics and hospitalisations due to Hypospadias, a physical disorder. Apart from that I have never had anything close to psyhosis. Certainly nothing that medical professionals have observed.

* BP I requires meeting criteria for both a major depressive and a manic episode, which is not the case for ADHD. I have had one major depressive episode which lasted for 2 months, this year, despite being on full dose of Effexor (Venlafaxine). During this time I had persistent suidicide ideation although I never attempted it. I have never had a manic episode and my psychiatrist and psychologist have never reported seeing me elated or hypomanic. I am always subjectively euthymic or in low mood and drowsy.

* Family history of ADHD or BP. My father had similar symptoms to me, but he was never treated in his lifetime for any mental illness. He was once sent home from University due to being inappropriately "high". He did however have grandiosity and believed that himself and I were chosen by God to do his work, and that we were prophets. This was encouraged by the members of his evangelical/pentecostal church. My father was a musical elder at this church.

* Responses to medication - Those with ADHD respond poorly to mood stabilisers and rather well to stimulants. Conversely, those with a mood disorder may have a history of positive responses to antidepressant medication or mood stabilisers and not respond well to a stimulant. I am on Venlafaxine, Depakote and Risperidone and I still consistently experience Dysthymia, lack of attention, poor concentration, agitated hyperactivity and rapid thoughts.

The book says that a thorough and careful assessment of the individual s symtoms is imperative for correct diagnosis and treatment, I feel I need and deserve this, rather than being constantly checked for psychosis, mania or depression. My work history is consitently poor, I have an inability to focus on my work, and an inability to

Answer :
i didn t read it all but have been diagnosed with ADD and ADHD. i can tell you right now that if you have been diagnosed with bipolar disorder they will not let you take any ADHD medication as it increases the risk of suicide. if you don t like what your doc is saying, visit another one, but like i said no doctor will give you ADHD meds while you re on bipolar meds. good luck