University:
Stanford University
Course:
MED 101 | Human Anatomy
Academic year:

2023
Views:

362

Pages:

2
Author:

larbi43100

‭Psychotherapies :‬ ‭●‬ ‭This‬‭mainly‬‭involves‬‭psychoeducation‬‭of‬‭the‬‭patient‬‭and‬‭his‬‭family:‬‭explaining‬‭the‬‭illness‬‭and‬ ‭the need for treatment to obtain a good therapeutic alliance and ensure good therapeutic compliance.‬ ‭The doctor must also insist on the hygienic and dietary rules:‬ ‭-Avoidance of toxic substances (alcohol, cannabis, other toxic substances)‬ ‭-Eviction or reduction of stimulants (coffee, tea, tobacco, amphetamines)‬ ‭-Avoidance of certain drug treatments (corticosteroids)‬ ‭-Good regularity of sleep-wake cycles (avoid sleepless nights and phase shifts)‬ ‭-Environmental planning (work, leisure, etc.) for better management of stress factors‬ ‭●‬ ‭Other more structured psychotherapies can be offered such as:‬ ‭-‬ ‭Psychotherapy, focused on stress management.‬ ‭-‬ ‭Cognitive behavioral therapy: especially in depression‬ ‭Therapeutic modalities‬ ‭Curative treatment for manic episode‬ ‭✪This is a therapeutic emergency. Hospitalization is obligatory. It can be done freely or under‬ ‭constraint.‬ ‭✪It helps protect the patient against possible medico-legal acts.‬ ‭✪It makes it possible to initiate treatment if it is a first access and to impose it in the event of refusal.‬ ‭Lithium salts are used first line unless contraindicated in combination with antipsychotics to manage‬ ‭agitation.‬ ‭✪To chemotherapy, we add psychoeducational measures and hygienic-dietary rules.‬ ‭Curative treatment of depressive episode‬‭:‬ ‭✪Hospitalization is often necessary‬ ‭✪The treatment of choice is a monotherapy mood stabilizer.‬ ‭Lithium is indicated as first-line treatment but is less effective in depressive episodes compared to‬ ‭manic episodes.‬ ‭✪Recently, lamotrigine and aquetiapine have been shown to be of particular interest in first-line bipolar‬ ‭depression.‬ ‭✪The Antidepressant is recommended in severe or resistant attacks, always under the cover of a‬ ‭mood stabilizer given the risk of turning or worsening towards a form with rapid cycles. Preventive‬ ‭treatment for bipolar disorder:‬ ‭✪The‬ ‭objective‬ ‭of‬ ‭prophylactic‬ ‭treatment‬ ‭is‬ ‭to‬ ‭reduce‬ ‭relapses,‬ ‭interictal‬ ‭symptoms,‬ ‭suicidal‬ ‭risk,‬ ‭cycle frequency and mood instability, but also more generally to improve patients' quality of life.‬ ‭✪Firstly,‬ ‭we‬ ‭favor‬ ‭monotherapy‬ ‭with‬ ‭a‬ ‭mood‬ ‭stabilizer,‬ ‭retaining‬ ‭the‬‭one‬‭that‬‭has‬‭proven‬‭effective‬ ‭during the acute phase.‬ ‭✪Lithium‬‭is‬‭the‬‭first-line‬‭treatment.‬‭In‬‭the‬‭event‬‭of‬‭intolerance‬‭or‬‭contraindication‬‭to‬‭lithium,‬‭another‬ ‭TR should be considered.‬ ‭✪Drug treatment must always be associated with psychoeducational and social measures.‬