Complexity of bipolar disorder treatment in clinical practice

Consultant Psychiatrist Dr Patrick Devitt and Registrar Dr Sinead Murphy at Adelaide and Meath Hospital look at the current use of mood-stabilisers in an empirical mix-and-match fashion to treat bipolar affective disorder Severe cases of bipolar affective disorder are very difficult to treat. A large proportion of patients present in an undifferentiated, chaotic way, making early diagnosis difficult. Treatment, therefore, is often empirical and apparently haphazard, involving various combinations of mood-stabilizers, anti-psychotics and benzodiazepines. Hospitalisation is frequently necessary for the safety of patients and others. {openx:269} h4. Case scenarios The following, not uncommon, case scenarios illustrate the complex and multifactorial…