Bipolar disorder can be challenging to diagnose and manage. It is often assumed to be recurrent major depression, until an episode of mania/hypomania occurs and the diagnosis of bipolar disorder is confirmed, usually by a Psychiatrist. Mood stabilising medicines, e.g. lithium and valproate, are the mainstay of pharmacological treatment. Monotherapy with antidepressants for a patient with bipolar disorder is associated with an increased risk of an episode of mania and should be avoided. A key role of general practice in the long-term management of patients with bipolar disorder is to educate the patient and their family about their condition, to encourage treatment adherence and a healthy lifestyle, to assess for treatment efficacy and monitor for adverse effects.
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