Medical Grand Rounds

Diagnosing and treating bipolar disorder in primary care

Parashar Koirala, MD and Amit Anand, MD
Cleveland Clinic Journal of Medicine August 2018, 85 (8) 601-608; DOI: https://doi.org/10.3949/ccjm.85gr.18003

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Tables

  • TABLE 1

    Conditions associated with bipolar disorders

    Migraine
    Thyroid disease
    Overweight and obesity
    Diabetes
    Cardiovascular disease and hypertension
    Chronic obstructive pulmonary disease
    Human immunodeficiency virus infection, hepatitis C virus infection, sexually transmitted disease, disease related to drug abuse
    Accident, injury
  • TABLE 2

    Medications that can induce manic symptoms

    Antidepressants
    Stimulants
    Steroids
    Antiparkinsonian or dopaminergic drugs: carbidopa, levodopa, pramipexole
    Levothyroxine
    Cyclosporine
    Antibiotics: ciprofloxacin, gentamicin
    Chloroquine
    Cancer drugs: fluorouracil, ifosfamide
  • TABLE 3

    Side effects of treatments for bipolar disorder

    Lithium
    Cognitive impairment
    Weight gain
    Thyroid effects
    Polydipsia, polyuria
    Tremor
    Renal toxicity
    Valproate
    Weight gain
    Alopecia
    Hematologic toxicity
    Cognitive impairment
    Hepatic toxicity
    Pancreatitis
    Carbamazepine
    Rash
    Drug interactions
    Hematologic and hepatic toxicity
    Antipsychotics
    Weight gain
    Diabetes risk
    Extrapyramidal symptoms
    Benzodiazepines
    Abuse potential
    Cognitive impairment
    Sedation
    Antidepressants
    Can trigger mania
    Selective serotonin reuptake inhibitors: akathisia (feeling of restlessness)
    Tricyclic antidepressants: anticholinergic effects
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