what is abilify?

source:ABILIFY.COM
REMEMBER:ITS BETTER YOU CONSULT YOUR DOCTOR FIRST

Elderly people with psychosis related to dementia (for example, an inability to perform daily activities as a result of increased memory loss), treated with antipsychotic medicines including ABILIFY, are at an increased risk of death compared to placebo. ABILIFY is not approved for the treatment of people with dementia-related psychosis

IMPORTANT SAFETY INFORMATION and INDICATIONS for ABILIFY^® (aripiprazole)

IMPORTANT SAFETY INFORMATION:

Elderly people with psychosis related to dementia (for example, an inability to perform daily activities as a result of increased memory loss), treated with antipsychotic medicines including ABILIFY, are at an increased risk of death compared to placebo. ABILIFY is not approved for the treatment of people with dementia-related psychosis (see Boxed WARNING).

Antidepressants may increase suicidal thoughts or behaviors in some children, teenagers, and young adults, especially within the first few months of treatment or when the dose is changed. Depression and other serious mental illnesses are themselves associated with an increase in the risk of suicide. Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Such symptoms should be reported to the patient's healthcare provider right away, especially if they are severe or occur suddenly. ABILIFY is not approved for use in pediatric patients with depression (see Boxed WARNING).

Contraindication: Patients should not use ABILIFY if they are allergic to aripiprazole or any of the ingredients in ABILIFY. Allergic reactions have ranged from rash, hives and itching to anaphylaxis, which may include difficulty breathing, tightness in the chest, and swelling of the mouth, face, lips, or tongue.

Serious side effects may include:

• An increased risk of stroke and ministroke have been reported in clinical studies of elderly people with dementia-related psychosis
• High fever, stiff muscles, confusion, sweating, changes in pulse, heart rate, and blood pressure may be signs of a condition called
  neuroleptic malignant syndrome (NMS), a rare and serious condition that can lead to death
• Increases in blood sugar levels (hyperglycemia) can happen in some people who take ABILIFY. Extremely high blood sugar can lead to coma or death. If you havediabetes, or risk factors (for example, obesity, family history of diabetes), or have the following symptoms: increases in thirst, urination, or hunger, feel weak or tired, sick to your stomach, or confused (or breath smells fruity), your blood sugar should be monitored
• Changes in cholesterol and triglyceride (fat, also called lipids) levels in the blood have been seen in patients taking medicines like ABILIFY
• Weight gain has been reported in patients taking medicines like ABILIFY so your weight should be checked regularly. Weight gain in children (ages 6 to 17) should be compared against that expected with normal growth
• ABILIFY and medicines like it have been associated with difficulty swallowing which may lead to aspiration or choking
• Uncontrollable movements of face, tongue, or other parts of body, as these may be signs of a serious condition called tardive dyskinesia (TD). TD may not go away, even if you stop taking ABILIFY. TD may also start after you stop taking ABILIFY
• Orthostatic hypotension (decreased blood pressure) or lightheadedness or fainting when rising too quickly from a sitting or lying position has been reported with ABILIFY
• Decreases in white blood cells (WBC; infection fighting cells) have been reported in some patients taking ABILIFY. Patients with a history of a significant decrease in WBC count or who have experienced a low WBC count due to drug therapy should have their blood tested and monitored during the first few months of therapy
• Seizures (convulsions) have been reported with ABILIFY. Tell your healthcare provider if you have a history of or are at risk for seizures
• ABILIFY and medicines like it can affect your judgment, thinking, or motor skills. You should not drive or operate hazardous machinery until you know how ABILIFY affects you
• Medicines like ABILIFY can impact your body’s ability to reduce body temperature; you should avoid overheating and dehydration
• Tell your healthcare provider if you are pregnant or intend to become pregnant. Also tell your healthcare provider about any other medical conditions you have and about all prescription and non-prescription medicines you are taking or plan to take since there are some risks for drug interactions

While taking ABILIFY, avoid:

• Drinking alcohol
• Breast-feeding an infant

Most common side effects (≥10%) from all clinical trials involving adults or pediatric patients include:

• ADULTS: Nausea, vomiting, constipation, headache, dizziness, an inner sense of restlessness or need to move (akathisia), anxiety, insomnia, and restlessness
• PEDIATRIC PATIENTS (6 to 17 years): Sleepiness, headache, vomiting, extrapyramidal disorder (for example, uncontrolled movement disorders or muscle disturbances such as restlessness, tremors, and muscle stiffness), fatigue, increased appetite, insomnia, nausea, stuffy nose, and weight gain

It is important to contact your healthcare provider if you experience prolonged, abnormal muscle spasms or contractions, which may be signs of a condition called dystonia.

For patients who must limit their sugar intake, ABILIFY Oral Solution contains sugar.

For patients with phenylketonuria or PKU, ABILIFY DISCMELT^® (aripiprazole) contains phenylalanine.

If you have any questions about your health or medicines, talk to your healthcare provider.

INDICATIONS: ABILIFY is indicated for:

• Use as an add-on treatment to an antidepressant for adults with Major Depressive Disorder who have had an inadequate response to antidepressant therapy
• Treatment of manic or mixed episodes associated with Bipolar I Disorder in adults and in pediatric patients 10 to 17 years of age
• Treatment of Schizophrenia in adults and in adolescents 13 to 17 years of age
• Treatment of irritability associated with Autistic Disorder in pediatric patients 6 to 17 years of age

Special Considerations for Pediatric Uses:

• Discuss the risks and benefits of treatment with your child’s healthcare provider. Treatment should be started only after a thorough diagnostic evaluation and as part of a total treatment program

Bipolar Disorder and the Creative Mind 2

by:liz paterek
source:brynmawr.edu

There is an old stereotype that artists are moody individuals prone to fits of depression and madness. Is this little more than an old wives tale? Many artists and writers speak of periods of increased mental fluidity and lifted mood ((4)). Poets such as Edgar Allan Poe and Emily Dickinson, novelists such as Mary Shelley and Leo Tolstoy and artists such as Michelangelo and Vincent Van Gogh have all be reported to show signs mental instability ((2)). How common is depression in artists compared to other creative professions? If there is a trend, is it because this bipolar nature generates a new way to see the world? Are the arts a refuge for mentally unstable? Is artistic genius linked with madness?
Major depression strikes as many as 5% of the general population, often later in life and is more common in women. Bipolar affective disorder, which involves phases of mania and depression, is known to strike 1% of the population, with the numbers of men and women being similar ((1b)). Mania is expressed by periods of extreme productivity, grandiosity, hyperactivity and irritability lasting for at least a week. Hypomania is a less severe form of this disorder also involved in manic depression. Major depression must last for periods of at least 4 weeks and is characterized by inability to concentrate, feelings of worthlessness and fatigue ((5), (3)).
Memory and creativity are related to mania. Clinical studies have shown that those in a manic state will rhyme, find synonyms and use alliteration more than controls. This mental fluidity could contribute to an increase in creativity. Moreover mania creates increases in productivity and energy. Those in a manic state are more emotionally sensitive and show less inhibition about attitudes, which could create greater expression ((3)). Studies performed at Harvard looked into the amount of original thinking in solving creative tasks. Bipolar individuals, whose disorder was not severe, tended to show greater degrees of creativity ((5)).
Bipolar disorder is not the first to be linked to creativity. During the 1960's, it was alcoholism. Before that, many artists, including Keats, Shelley, and Poe were thought to have fatal diseases such as tuberculosis. However, these diseases all are linked by symptoms. Tuberculosis has manic and depressive phases, which gives credence to the idea that artists experience mood swings ((2)). Alcoholism is linked to mania and depression ((3)).
There have been studies pointing to a link between manic-depression and left-brained talents. When Nancy C. Andreasen of the University of Iowa questioned 30 writers, she found that at least 80% had had at least one episode of major depression, mania or hypomania compared to 30% of controls ((2), (5)). Another researcher, Rothenburg, who has spent 30 years studying creative individuals, objects to her control groups and her methods ((2)). Later when Kay Redfield Jamison studied 47 writers, painters, and sculptors, she found that 30% had been treated for bipolar disorder ((2), (5)). Half of the poets studied were treated for bipolar disorder ((5)).
While these samples are small and it is difficult to judge prominence of many living individuals, there is a trend. Some diagnosis of the past has been performed to help confirm this data. This is based on second hand information and has its flaws ((2)). The way individuals are portrayed by others will be scattered, because they do not know all aspects of a person's life. All people have quirks, if one wanted to see insanity, it would be easy to exaggerate them. However, if this data is supportive, it will cement the trend.
Artists in generations past have been shown to have suicide rates 10-20 times higher than the general population and higher than average rates of hospitalization for depression ((1b)). Another researcher, Ludwig, delved into depression in prominent 20th century individuals based on 2,200 biographies of 1,004 individuals. He showed that while 11% of creative individuals suffered from mania; only 1% of the general population did. He also showed 46 to 77% suffered from depression, almost twice the rate in the general population ((1c)). He found that accomplished individuals in other fields, including science, had only a 3% rate of depression. He believed the biographers were less likely than psychiatrists to believe that a person had a mental disorder and that clinical stories are autobiographies which are the most inaccurate understanding of a person ((2)). Despite any flaws in how these experiments have been performed, the trend persists. Therefore it is important to ask why this trend exists.
While Jamison and Andreasen argued that bipolar disorder enhances creativity, Ludwig argued that individuals who are creative but manic are more likely to find a home in art rather than other fields ((2)). According the Ludwig, the sciences require organization, preparedness and levelheadedness. An artist could draw on the lack of these traits for inspiration; a scientist could not ((2)).
There is the question of different forms of intelligence. A scientist may not be an outstanding poet nor is an outstanding poet likely to be great at physics. At an elite level, talents are often focused in specific field. This is at least somewhat suggestive that there may be different brain connections that create different talents. Therefore a genius may not be able to choose to go between fields because of personality as Ludwig suggests.
The Jamison and Andreasen argument is shaken by the fact that around half of all great creative minds have not been bipolar; therefore manic phases could not cause their creativity. They have no data to suggest directionality of this link. It could just as likely be that artistic talents generate a predisposition for bipolar symptoms as it could be that being bipolar generates artistic abilities. The latter makes less sense because fewer bipolar individuals are artistic than artists are bipolar, as well as that those with severe mania are less creative than those with mild forms. While drug studies would seem to support the link that without manic phases creativity decreases, it would be better to realize that these drugs have broad effects and all effects may not be directly related ((2), (5)).
It is clear that being bipolar does not mean that one will necessarily be creative. It is also clear that being bipolar is not a requisite for genius. However, Hagop S. Akiskal found that 9-10 percent of those bipolar patients he studied with less severe symptoms were artists and writers ((1a)). The mind of a left-brained genius could be more vulnerable to mood swings, which manifest similarly to normal bipolar symptoms. Therefore the symptoms would not exist in all geniuses but in many. The connections in the brain that cause this genius may be different from those who express right brained talents. This would explain why geniuses in other fields do not show the same symptoms. It would also keep the link between mania and creativity that Ludwig's argument does not.
Left brained creativity could be a vulnerability factor to developing symptoms of bipolar disorder. Studies present a seemingly clear link between bipolar disorder and artistic creativity. This would account for the reason other individuals in creative fields, such as science, do not show the same results. Because talent is often focused, it is unlikely that a manic individual chooses art. Because not all bipolar minds are creative but many creative minds are bipolar, it seems likely that bipolar disorder generates vulnerability for bipolar symptoms. Because it is only a vulnerability factor, many people will not suffer from it while still having talent.

Living with bipolar disorder

source:lifeloveandbipolar.com

Living with a bipolar disorder individual in the home can be a stressful problem for the family as they witness their loved ones engulfed in episodes of mania and depression.

The same factors that would pose threats to peaceful family life for any family pose greater risks when living with a bipolar individual. Alcohol and drug abuse, lies, reckless spending, rage, depression, hypersexuality, suicidal inclinations, and hallucinations all have the potential to upset family peace and integrity.

To minimize risk family, friends and sufferer need coping mechanisms. This usually boils down to rather more in the way of routine, organization, forward planning and a sense of humor than normal. There is no disputing the power of laughter to improve ones sense of wellbeing to elevate the mood and help keep things in perspective.

It is important to know that few bipolar patients are dangerous so there is no need to feel physically threatened. Assuming they have been correctly diagnosed and are monitored by health professionals the disruptions to normal family life will be minimized.

Disruptions are more likely if the person has not yet been diagnosed, or misdiagnosed, or for whatever reason doesn't take the prescribed medications.

The best course of action for any support team is to seek help as soon as possible if the behavior of the individual is beyond what could be considered reasonable or normal even if the individual denies there being anything wrong and sees nothing unusual in their behavior.

Identify triggers i.e. stressful life events that are likely to spark the episodes of mania or depression. These might be memories of events like deaths, anniversaries, traumas, or the like. Keep a record of such events in your journal and learn to insulate your bipolar family member from them.

Living with bipolar disorder requires fighting not only your own irritation but also, and more importantly, the fears of the bipolar person. They have a craving for being in control of situations which is rooted in their fear of losing control and the attention of the family. With a lot of patience love and care family and friends can help abate these fears and provide help and support in social situations.

Manic episodes with psychotic features like hallucinations (voices, sounds etc) can occur with bipolar 1 individuals. What seems real to the patient might be construed as nonsense or bipolar lying to others. It is important to understand that "reality" is different for the sufferer who is simply recalling the experience as perceived. Acceptance of this relativism of reality goes a long way to curbing anger in such situations

List of figures/doctors in psychiatry

soucre:wikipedia.org

Psychiatrists	Speciality
Alfred Adler	Individual psychology
Nancy C. Andreasen	Schizophrenia
Vittorino Andreoli	Psychiatric anthropology
Franco Basaglia	Antipsychiatry
Jack Barchas	Biological basis of schizophrenia
Aaron Beck	Cognitive therapy
Wilfred Bion	Psychoanalysis and group therapy
Eugene Bleuler	Diagnostic criteria for schizophrenia
John Bowlby	Attachment behavior
Ian Brockington	Nosological pioneer
John Cade	Lithium therapy
Ugo Cerletti	Electroconvulsive therapy
Edmund Chiu	Huntington's chorea
Tim Crow	Biological basis of schizophrenia
Pierre Deniker	Chlorpromazine
Leon Eisenberg	Psychiatric anthropology
Milton Erickson	Hypnosis
Jean Etienne Esquirol	Descriptive psychopathology, postnatal depression
Frantz Fanon	Effects of discrimination
Daniel X. Freedman	Biological psychiatry
Christopher Paul Lindsay Freeman	Electroconvulsive therapy
Sigmund Freud	Psychoanalysis
William Glasser	Reality therapy, Choice theory
Max Hamilton	Depression and anxiety scales
Albert Hofmann	Father of LSD
Kevin Gournay	Schizophrenia, Depression and Cognitive Therapy
Karen Horney	Womb envy
Pierre Janet	Dissociation
Karl Jaspers	Phenomenology
Eve Johnstone	Brain changes in schizophrenia
Maxwell Jones	Therapeutic community
Carl Gustav Jung	Analytical psychology
Seymour Kety	Psychiatric genetics
Eric R. Kandel	Molecular basis for memory
Leo Kanner	Autism
Jacob Kasanin	Schizoaffective psychosis
Otto Kernberg	Psychoanalysis
Arthur Kleinman	Psychiatric anthropologist
Emil Kraepelin	Psychiatric methodology
Richard von Krafft-Ebing	Sexuality
Norman Krietman	Psychiatric epidemiology
Elisabeth Kübler-Ross	Stages of Grief
R. D. Laing	Antipsychiatry
Karl Leonhard	Classification of Psychosis,cycloid psychosis
Sir Aubrey Lewis	Nosology
Alwyn Lishman	Neuropsychiatry
Ali ibn Abbas al-Majusi (Haly Abbas)	Mental disorders
Abraham Maslow	Humanistic Psychology
Niall McLaren	Biocognitive Theory of the Mind
Peter McGuffin	Psychiatric genetics
Ladislas von Meduna	Pharmacoconvulsions
Adolf Meyer	Psychobiology
Egas Moniz	Psychosurgery
Jacob Moreno	Psychodrama and Group Psychotherapy
Robin Murray	Schizophrenia
John Nemiah	Psychotherapy
Ian Oswald	Sleep research
Ivan Pavlov	Conditioning
Eugene Paykel	Social psychiatry
Philippe Pinel	Psychiatric treatment
W. H. R. Rivers	Psychiatric anthropologist
Martin Roth	Psychogeriatrics
Michael Rutter	Child psychiatry
Kurt Schneider	Diagnostic criteria
Mogens Schou	Lithium therapy
Michael Shepherd	Psychiatric epidemiology
Peter Sifneos	Psychotherapy
Elliot Slater	Psychiatric epidemiology
Robert Spitzer	Diagnostic criteria
Solomon H.Snyder	Neurotransmitters
Harry Stack Sullivan	Interpersonal psychiatry
Hans Steiner	Child Psychiatry
Thomas Szasz	Antipsychiatry
Eng Seong Tan	Cross-cultural psychiatry
Fuller Torrey	Treatment of schizophrenia
Ming Tsuang	Psychiatric genetics
John Batty Tuke	Neuroscientist
Julius Wagner-Jauregg	Treatment of GPI
Paul Watzlawick	Communication theory of mental health
Sula Wolff	Stress in children
Irvin Yalom	Group and existential psychotherapy

Alphabetic List

Aaron Beck Cognitive therapy
Abraham Maslow Humanistic Psychology
Adolf Meyer Psychobiology
Albert Hofmann Father of LSD
Alfred Adler Individual psychology
Ali ibn Abbas al-Majusi (Haly Abbas) Mental disorders
Alwyn Lishman Neuropsychiatry
Arthur Kleinman Psychiatric anthropologist
Carl Gustav Jung Analytical psychology
Christopher Paul Lindsay Freeman Electroconvulsive therapy
Daniel X Freedman Biological psychiatry
Edmund Chiu Huntington's chorea
Egas Moniz Psychosurgery
Elisabeth Kübler-Ross Stages of Grief
Elliot Slater Psychiatric epidemiology
Emil Kraepelin Psychiatric methodology
Eng Seong Tan Cross-cultural psychiatry
Eric R. Kandel Molecular basis for memory
Eugene Bleuler Diagnostic criteria for schizophrenia
Eugene Paykel Social psychiatry
Eve Johnstone Brain changes in schizophrenia
Franco Basaglia Antipsychiatry
Frantz Fanon Effects of discrimination
Fuller Torrey Treatment of schizophrenia
Harry Stack Sullivan Interpersonal psychiatry
Ian Brockington Nosological pioneer
Ian Oswald Sleep research
Irvin Yalom Group psychotherapy
Ivan Pavlov Conditioning
Jack Barchas Biological basis of schizophrenia
Jacob Moreno Psychodrama and Group Psychotherapy
Jean Etienne Esquirol Descriptive psychopathology, postnatal depression
John Batty Tuke Neuroscientist
John Bowlby Attachment behaviour
John Cade Lithium therapy
John Nemiah Psychotherapy
Julius Wagner-Jauregg Treatment of GPI
Karen Horney Womb envy
Karl Jaspers Phenomenology
Karl Leonhard Classification of Psychosis, cycloid psychosis
Kurt Schneider Diagnostic criteria
Ladislas von Meduna Pharmacoconvulsions
Leo Kanner Autism
Leon Eisenberg Psychiatric anthropology
Martin Roth Psychogeriatrics
Max Hamilton Depression and anxiety scales
Maxwell Jones Therapeutic community
Michael Rutter Child psychiatry
Michael Shepherd Psychiatric epidemiology
Milton Erickson Hypnosis
Ming Tsuang Psychiatric genetics
Mogens Schou Lithium therapy
Nancy C. Andreasen Schizophrenia
Niall McLaren Biocognitive Theory of the Mind
Norman Krietman Psychiatric epidemiology
Otto Kernberg Psychoanalysis
Paul Watzlawick Communication theory of mental health
Peter McGuffin Psychiatric genetics
Peter Sifneos Psychotherapy
Philippe Pinel Psychiatric treatment
Pierre Deniker Chlorpromazine
Pierre Janet Dissociation
R. D. Laing Antipsychiatry
Richard von Krafft-Ebbing Sexuality
Robert Spitzer Diagnostic criteria
Robin Murray Schizophrenia
Seymour Kety Psychiatric genetics
Sigmund Freud Psychoanalysis
Sir Aubrey Lewis Nosology
Solomon H. Snyder Neurotransmitters
Sula Wolff Stress in children
Thomas Szasz Antipsychiatry
Tim Crow Biological basis of schizophrenia
Ugo Cerletti Electroconvulsive therapy
Vittorino Andreoli Psychiatric anthropologist
W. H. R. Rivers Psychiatric anthropologist
Wilfred Bion Psychoanalysis and group therapy
William Glasser Reality therapy, Choice theory

Distinguishing ADHD from juvenile bipolar disorder: A guide for primary care PAs

source:jaapa.com

                                                                                                 

For the past two decades, there has been an ongoing debate regarding the methodology employed to differentially diagnose attention-deficit/hyperactivity disorder (ADHD) and juvenile-onset bipolar disorder (JBPD).¹ ADHD and bipolar disorder are listed as separate diagnoses in theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR); however, the diagnostic criteria overlap, making the differential diagnosis problematic.² Although the accuracy of diagnosis among these disorders has been investigated for years, it has become increasingly relevant as growing numbers of children with severe emotional and behavioral difficulties are identified.³

Attention-deficit/hyperactivity disorder

ADHD is considered the most researched and commonly diagnosed psychiatric disorder of childhood.^4,5 It is characterized by a triad of symptoms (hyperactivity, inattention, and/or impulsivity) that cause impairment in the child's social, educational, relational, occupational, and self-sufficiency roles.⁶ Estimates suggest that ADHD occurs in 5% to 9% of school-age children and is three times more common in boys.⁷ Theories suggest that boys are more likely to receive a diagnosis of the hyperactive subtype since they are more likely to exhibit aggressive, externalizing types of behaviors. Girls are more likely to receive a diagnosis of the inattentive subtype because they are less likely to exhibit the more attention-grabbing symptoms, appearing instead to have more problems with inattention.⁸

For a diagnosis of ADHD, the child must exhibit hyperactive, inattentive, and/or impulsive symptoms before the age of 7 years.² There is lack of empiric support for this established age criterion, however, and it has been criticized as overly restrictive.⁹ Nevertheless, ADHD remains a common childhood diagnosis given to children with uncomplicated forms of the disorder as well as to others with severe disability and comorbidity (eg, depression, conduct disorder, and oppositional defiant disorder).¹⁰

Juvenile-onset bipolar disorder

Historically, JBPD has been less common than ADHD, with an estimated prevalence of 1% to 2%.¹¹ More recently, recognition of bipolar symptoms in children has been growing.^5,12 The increased diagnosis of JBPD stems primarily from an amended concept of bipolar disorder.¹³ Early investigators hypothesized that the disorder would manifest as it does in adults, with distinct episodes of mania and depression, and would be easily differentiated from ADHD.¹⁴ It has become apparent, however, that JBPD's initial manifestations and clinical course distinguish it from adult-onset bipolar disorder (ABPD) and that its signs and symptoms are more similar to those of ADHD.⁷

Unlike ABPD, JBPD is often characterized by a chronic, rapid-cycling, irritable course with symptoms of mania and depression occurring simultaneously.⁵ The classic symptoms of mania often found in ABPD may be absent or difficult to detect in JBPD. Manifestations of JBPD that make it difficult to distinguish from ADHD (and particularly ADHD with comorbid oppositional defiant disorder) include aggressive behaviors, severe affective outbursts or explosive anger, extreme temper tantrums, and increased impulsivity, hyperactivity, and inattention.^11,13

Comorbidity

JBPD is often diagnosed along with other disorders. Up to 24% of affected children present with more than three comorbid conditions.¹

Researchers suggest that 57% to 100% of children with JBPD have comorbid ADHD, while only 11% to 22% of children with ADHD also have JBPD.⁷ Other research suggests that the younger the child when bipolar disorder is diagnosed, the more likely ADHD is to be present also.¹⁵ In a study of adolescent patients with bipolar disorder, 88% with the childhood-onset form and 59% with the adolescent-onset form had comorbid ADHD.¹⁵ Some clinicians and researchers have questioned these comorbidity figures, suggesting that they can be explained by overlapping symptoms, confusion of normal developmental behaviors, and/or shared genetic vulnerabilities.¹⁶Others argue that manic symptoms are not being adequately differentiated from hyperactive symptoms.¹⁷ Some have suggested that children with comorbid JBPD and ADHD have a familial subtype of bipolar disorder.¹⁸Limited diagnostic criteria make overlapping symptoms even more difficult to interpret (see Table 1). In fact, the DSM-IV-TR does not provide distinct diagnostic criteria for JBPD.^4,5 Investigators have attempted to establish consensual definitions and working guidelines for JBPD and ADHD.¹⁹

Presentation

Patients with JBPD and ADHD present with irritability, hyperactivity, accelerated speech, and distractibility. ²⁰ JBPD produces chronic rapid cycling rather than the episodic cycling found in ABPD, so symptoms may appear continuous (ultradian); this makes distinguishing JBPD from ADHD more difficult.¹ Symptoms that the DSM-IV-TR associates with prepubertal mania are not seen in ADHD, however, and may aid in diagnosis. Researchers and clinicians have suggested that these important signs of JBPD (elation, grandiosity, flight of ideas/racing thoughts, decreased need for sleep, and hypersexuality) should receive more attention.²¹There are other distinct manifestations of JBPD, such as extreme and frequent mood lability, extended tantrums, extreme aggression, suicidality (suicidal thinking and behavior), grandiose or self-accusatory delusions, and hallucinations.¹ Additionally, researchers have found that children with JBPD—unlike those with ADHD— have significant elevations on the Child Behavior Checklist (CBCL), a measure of child behavior problems. These elevations indicate more delinquency, aggression, anxiety, depression, and thought problems.²²

By resolving the diagnostic dilemma and providing prophylactic pharmacotherapy, practitioners can reduce the psychiatric and psychosocial morbidity associated with JBPD.²² Medications commonly used to treat ADHD, such as CNS stimulants, atomoxetine, and antidepressants, may be ineffective for children with JBPD and may even exacerbate bipolar symptoms.¹ Also, the use of antidepressants and stimulants in children may trigger mania and result in an earlier onset of bipolar disorder. ¹² The FDA's health advisory suggesting that children and adolescents taking antidepressants may be at increased risk for suicidality highlights the importance of an accurate differential diagnosis.

In light of the significant changes in the health care system and increased demands to improve productivity while containing costs, PAs have become critical members of the pediatric team.²³ As a result, it is imperative that PAs have an accurate understanding of ADHD and JBPD and that they understand the nuances of the differential diagnosis in this population.

Diagnosis

Since the process of diagnosing ADHD and/or JBPD is multifaceted, primary care providers, pediatric psychologists, and psychiatrists often compose the diagnostic team. Many biological and psychological conditions can manifest similarly to ADHD or JBPD. A thorough evaluation should include a complete history and physical examination, laboratory tests, clinical interviews with the child and parent, behavioral rating scales, and other testing as deemed appropriate. The findings from these assessments are then compared to the diagnostic criteria listed in the DSM-IV-TR.^24,25 

Diagnosis of Juvenile Bipolar

source:ehow.com

According to the Juvenile Bipolar Research Foundation, as many as one million adolescents and children are affected by bipolar disorder each year.

Common Misdiagnoses

• Children with bipolar disorder are often diagnosed with attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD). Most kids with bipolar disorder meet the criteria for these other disorders, so a comprehensive evaluation is important.

ADHD vs. Bipolar Disorder

• Kids with bipolar disorder generally appear more angry than do kids with ADHD. Children and adolescents with bipolar disorder also tend to have terrifying, gory nightmares, unlike kids with ADHD.
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Symptoms

• Juvenile bipolar disorder can cause hyperactivity, inattention, bossiness, defiance and temper tantrums. Parents of kids with bipolar disorder often report that even in infancy, their children were restless, slept little and were hard to calm. Moodiness is a key factor, and children may be very outgoing and charming or socially awkward and shy.

Getting Help

• If you're concerned about your child's behavior or moods, have your pediatrician make a referral to a clinical psychologist or developmental pediatrician experienced in juvenile mood disorders.

Making the Diagnosis

• The doctor will take a complete family history and assess your child's symptoms. He may order further testing to rule out physical reasons for your child's behavior.

Read more: Diagnosis of Juvenile Bipolar | eHow.com http://www.ehow.com/facts_5402229_diagnosis-juvenile-bipolar.html#ixzz23MZn4KC8

bipolar disorder medication list

source:about.com

REMEMBER:IT'S BETTER AND MORE ADVISABLE TO CONSULT YOUR DOCTOR..... DON'T DRINK WITHOUT DOCTOR PRESCRIPTION   

A

Abilify
Adapin
Alprazolam
Amitril
Amitriptyline
Amlodipine
Amoxapine
Anafranil
Apo-Alpzar
Apo-Amitriptyline
Aripiprazole
Asendin
Ativan
Atretol
Aventyl

B 

Benzodiazepines
Bupropion

C 

Calan
Carbamazepine
Carbolith
Celexa
Chlordiazepoxide
Chlorpromazine
Cibalith-S
Cipralex
Citalopram
Clomipramine
Clonazepam
Clopixol
Clozapine
Clozaril

 D 

Dalmane
Depakene
Depakote
Desipramine
Desyrel
Diazepam
Divalproex Sodium
Doxepin
Duralith

E 

Effexor
Elavil
Elavil Plus
Endep
Enovil
Epitol
Epival
Escitalopram
Etrafon
Etrafon-A
Etrafon-Forte

F 

Fluanxol
Fluoxetine
Flupenthixol
Fluphenazine
Flurazepam
Fluvoxamine

G 

Gabapentin
Geodon

H 

Halcion
Haldol
Haloperidol

I 

Imipramine
Isoptin

K 

Klonopin

L 

Lamictal
Lamotrigine
Levate
Lexapro
Libritabs
Librium
Limbitrol
Limbitrol DS
Lithane
Lithium
Lithobid
Lithonate
Lithotabs
Lorazepam
Luvox

M 

Manerix
Moclobemide

N 

Nardil
Nefazodone
Neurontin
Norpramin
Nortriptyline
Norvasc
Novo-Alprazol
Nu-Alpraz

O 

Oxcarbazepine
Olanzapine
Oxazepam

P 

Pamelor
Parnate
Paroxetine
Paxil
Permitil
Pertofrane
Phenelzine
Prolixin
Prozac

R 

Rivotril

S 

Serax
Serzone
Sinequan
Symbyax

T 

Thorazine
Tofranil
Tranylcypromine
Tegretol
Topamax (Topiramate)
Trazodone
Triavil
Triazolam
Trileptal

V 

Valium
Valproate
Valproic Acid
Venlafaxine
Verapamil

W 

Wellbutrin

X 

Xanax

Z 

Ziprasidone
Zoloft
Zuclopenthixol
Zyban
Zyprexa