Discuss the differential diagnosis of bipolar disorder and major depressive disorder.
Discuss the differential diagnosis of bipolar disorder and major depressive disorder.
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The overarching aim of the activity is to differentiate bipolar disorder from major depressive disorder. The learner objectives are as follows:
(a) Discuss the differential diagnosis of bipolar disorder and major depressive disorder.
(b) Identify patients at risk of bipolar disorder.
(c) Construct evidence-based patient treatment plans based on patient and disease state-specific characteristics.
The patient is diagnosed with bipolar I disorder, current episode depressed. The patient’s maternal history of bipolar disorder and poor response to antidepressants in the past lead the clinician to suspect a bipolar disorder diagnosis. Family history is an important risk factor, and a first-degree relative diagnosed with bipolar disorder should raise suspicion. The history of mania confirmed the diagnosis of bipolar I disorder. Considering the patient’s fear of needles and expressed concern about weight gain, atypical antipsychotics are preferred. Specifically, the clinician should recommend lurasidone, cariprazine or lumateperone. All three medications are proven to be effective for bipolar depression, and there is a relatively low risk for weight gain associated with each agent.
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