title: Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports.
abstract: BACKGROUND
  There is little published guideline or evidence on treating bipolar affective disorder in patients with renal failure having haemodialysis.
  
  
  METHODS
  We present two patients with bipolar affective disorder with renal failure having haemodialysis. We used lorazepam in one patient to manage the immediate risk of non-engagement with dialysis. Risperidone was added in the second patient for managing psychotic symptoms. Valproate was started as a mood stabiliser and titrated upwards for long-term management of the illness.
  
  
  CONCLUSIONS
  We discuss the similarities in the two cases and the care plan we used to manage them.
authors.affiliation: Lancashire Care NHS Foundation Trust, Parkwood Hospital, East Park Drive, Blackpool, FY3 8PW, UK. maneesh_psych@yahoo.com.
authors.forename: Maneesh
authors.initials: M
authors.lastname: Gupta
authors.forename: Srinivas
authors.initials: S
authors.lastname: Annadatha