[Bipolar disorders--how to recognize and treat them].
Bipolar disorders are often diagnosed too late with an average of ten years elapsing between the first disease episode and the correct diagnosis and treatment. The most common misdiagnoses are unipolar depression, schizophrenia and ADHD (Attention Deficit Hyperactivity Disorder). The suicide rate associated with bipolar disease is very high. Treatment consists in the administration of mood stabilizers, in the first instance lithium, but also atypical neuroleptics or lamotrigine. In the depressive phase, additional antidepressants or lamotrigine, in the manic phase valproate or an antipsychotic agent may be needed. Medication must be continued unchanged for several months beyond acute treatment. The subsequent relapse prophylaxis depends on effectiveness, tolerability, comorbidity, suicidal risk and compliance. Pharmacotherapy is supplemented by psychotherapy and psycho-education.
Grunze
H
H
Klinik und Poliklinik für Psychiatrie, LMU München. heinz.grunze@psy.med.uni-muenchen.de
Sasse
J
J
Forsthoff
A
A
Bauer
M
M
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005194:Family Practice; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D055502:Secondary Prevention
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D016651:Lithium Carbonate
Bei jeder Depression immer auch an bipolare Erkrankungen denken. Die verkannte Manie.