William James on Psychology as a Science

Last but not least

📌Manual based therapies (Interpersonal Social Rhythm therapy, CBT, Mindfulness)

📌 Severe episode (requiring hospitalization)
- Lithium or Divalproex + Aripiprazole, Asenapine, Quetiapine or Risperidone.

📌 If none of the above works

Consider Haloperidol or Olanzapine.

📌 If still no benefit move to Level 2 then Level 3 then Level 4 as indicated by the algorithm.

📌 In both BD-I and BD-II, if the patient was already started on a mood stabilizer previously then consider augmenting with Lirasidone or Lamotrigine.

(Cariprazine doesn’t have enough evidence with it comes down to augmentation with mood stabilizer)

📌 DUE (Duration of untreated Episode)
is strongly associated with increasein depression-related disability

The earlier you intervene the better the outcome (much like in Early Psychosis prevention programs)

(take history again as treatment resistance sometimes point to a faulty diagnosis)

STAR-D trial outcome- see second picture)

🧠Management Of Mood Disorders (Based on the 2017 Florida Medicaid guideline as expounded on by Prof @rogersmcintyre)

I have updated the changes within above mentioned guidelines with their 2019-2020 update.

💊 Psychopharmacology summaries and concepts: