mania (manic state)
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Etiology
- bipolar I disorder
- manic episode may be 1st manifestation
- pharmacologic causes:
- nitrate-cured meat products associated with mania in humans[5]
- new onset in elderly
- frontal lobe syndrome[4]
Epidemiology
- new onset mania uncommon in the elderly
Clinical manifestations
- hyperexcitability
- euphoria
- hyperactivity
- generally present manifestations
- rapid thinking & speaking
- agitation
- decreased need for sleep
- marked increase in energy
- grandiosity
- increased goal-directed activity
- impulsive behavior
- increased sexual activity
- aggression
- occasionally present manifestations
Laboratory
Differential diagnosis
- in contrast to a manic episode, during a hypomanic episode, functioning is preserved well enough to function at work or socially & does not require hospitalization
Management
- lithium more effective than divalproex for treatment of mania in elderly[3]
- see bipolar disorder
- specific treatment for specific etiology
More general terms
More specific terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39.
- ↑ Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ 3.0 3.1 Young RC, Mulsant BH, Sajatovic M et al. GERI-BD: A randomized double-blind controlled trial of lithium and divalproex in the treatment of mania in older patients with bipolar disorder. Am J Psychiatry 2017 Aug 4 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29088928 <Internet> http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.15050657
- ↑ 4.0 4.1 Taylor JB, Prager LM, Quijije NV, Schaefer PM. Case 21-2018: A 61-Year-Old Man with Grandiosity, Impulsivity, and Decreased Sleep. N Engl J Med 2018; 379:182-189. July 12, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29996076 https://www.nejm.org/doi/full/10.1056/NEJMcpc1712229
- ↑ 5.0 5.1 Khambadkone SG, Cordner ZA, Dickerson F et al. Nitrated meat products are associated with mania in humans and altered behavior and brain gene expression in rats. Mol Psychiatry 2018 Jul 18 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30022042 https://www.nature.com/articles/s41380-018-0105-6