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Source: Drayton SJ, Fields CS. Bipolar disorder. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=134127982.
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CONDITION/DISORDER SYNONYMS
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Theoretical causes:
Medical conditions that can induce mania:
Central nervous system (CNS) disorders.
Infections.
Electrolyte or metabolic abnormalities.
Endocrine or hormonal dysregulation.
Drug withdrawal syndromes.
Drugs that can induce mania:
Somatic therapies that induce mania:
Bright light therapy.
Deep brain stimulation.
Sleep deprivation.
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Various theories:
Dysregulation between excitatory and inhibitory neurotransmitter systems.
Excess of catecholamines (primarily norepinephrine and dopamine) causing mania.
Deficiency of gamma aminobutyric acid (GABA) or excessive glutamate activity causing dysregulation of neurotransmitters (eg, increased dopamine and norepinephrine activity)
Deficiency of acetylcholine causing imbalance in cholinergic-adrenergic activity.
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Lifetime prevalence: 1% for bipolar I, 1.1% for bipolar II, and 2.4% of patients with subthreshold bipolar disorder (cyclothymia, unspecified bipolar disorder).
Typical onset occurs in late adolescence or early adulthood.
Bipolar I disorder occurs equally in men and women; bipolar II disorder more common in women.
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80–90% of patients have biologic relative with mood disorder.
First-degree relatives of bipolar patients have 15–35% lifetime risk of developing any mood disorder and 5–10% lifetime risk for developing bipolar disorder.
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CLINICAL PRESENTATION
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MEANS OF CONFIRMATION AND DIAGNOSIS
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