00:00
Well, we have medications
that work quite well for them.
00:04
Mood stabilizers and reuptake
blockers can really help patients.
00:11
Valproate and Depakote.
00:13
These are anti-seizure medications
that have been demonstrated
to be very effective
as mood stabilizers.
00:22
We want to be understanding
that as we are using
these different
anti-seizure medications,
we're not saying the person
has a seizure disorder.
00:34
We have understood that
anti-seizure medications
can be very effective in
stabilizing these moods.
00:44
Lithium has been a go to medication
for mania for a very, very long time.
00:53
One of the problems with lithium, which
you will learn when you do your psychopharm
is that it has a very small window
and we have to be very careful.
01:02
So there's a lot of
blood tests going on
with that patient which
can also be disruptive.
01:09
Also antipsychotics like
Aripiprazole and Ziprasidone.
01:15
These are antipsychotics
that have been identified
as also being extremely
effective to work with patients
who have mood disorders.
01:30
Seroquel has also been
identified as a medication
that helps to equal out
these different moods.
01:41
The other thing that it does,
as well as the antipsychotics
is that sometimes with mania,
you have those delusions
and you have those
periods of time where you
have psychotic features.
01:57
When you are taking something like
an antipsychotic and Seroquel,
you find that these medications
will also reduce the likelihood
of psychotic features with a
person who has a mood disorder.
02:13
So there is a historical
progression that goes on,
we normally see that
with like 60% of people,
the manic episodes are right
before a major depressive episode.
02:27
So when we look at a continuum,
we see them going up into mania.
02:33
And then they come down into a depressive
episode of depressive disorder.
02:39
And then they go
back up into mania.
02:44
Sometimes we will say
it's rapid cycling,
which means they're really going
from a week of being really up to
3 weeks of being really
depressed and almost suicidal,
and then it starts
to get better again.
03:00
And there are usually more depressive
episodes than we see with mania.
03:07
This is just the way
the disease progresses.
03:11
Now when we think about it,
we have to really think about
the fact that this patient
when they are in a
depressive episode,
have a much higher likelihood
of contemplating suicide,
dying by taking their own life.
03:27
So we want to really
be aware of that.
03:31
When a person is
in a manic state,
we understand that they might
have the psychotic features,
you might find them walking
on a highway at night.
03:44
And because they really
wanted to have a cup of coffee
and they can't find
one that's open.
03:49
And so they just leave their car and
they start walking on the highway
because they have
so many thoughts.
03:54
So their life is still
at a very high risk.