9/2/2023 0 Comments Bipolar disorder manic episode![]() ![]() Pregnancy test: Pregnancy will affect treatment decisions.Urine toxicology screen: to rule out acute intoxication (e.g., with amphetamines).Urinalysis: may identify urinary tract infections.Monitoring studies depend on medications (e.g., serum levels of lithium or valproate, liver chemistries see also “ Overview of antipsychotics”).Additional studies based on the suspected underlying condition (e.g., evaluation for syphilis or frontotemporal dementia).Thyroid function tests: to rule out thyroid disease.BMP, liver chemistries: to establish a baseline before long-term pharmacological treatment.A complete history and physical examination should guide the requested studies. Studies help rule out differential diagnoses and detect conditions that may affect management. ![]() Patients with bipolar disorder are often misdiagnosed with major depressive disorder because the first presentation is usually a major depressive episode. All patients with suspected or confirmed bipolar disorder should be assessed promptly for suicide risk (especially during acute episodes) and evaluated by a psychiatrist. Patients with bipolar disorder have the highest suicide rate among patients with affective disorders.
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