Bipolar disorder goals

Based on all information presented, create a care plan for this patient s bipolar disorder. Your plan should include (1) a statement of the drug-related needs and/or problems, (2) the goals of therapy, (3) a patient-specific therapeutic plan, and (4) a plan for follow-up to assess therapeutic response and adverse effects. 

Chronic use has been associated with an "amotivational syndrome" characterized by loss of interest in social activities, school, work, or other goal-directed activities. Cannabis use is cited as the cause of this phenomenon, but there is no evidence to support any causal relationship. There is evidence, however, that the symptoms of the "amotivational syndrome" are secondary to depression (Musty and Kraback 1995). In contrast to ethanol, there is no evidence to support that cannabis causes an increase in violent behavior (Murray 1986). However, cannabis use may be contraindicated in those with preexisting psychiatric disturbances such as bipolar disorder or schizophrenia. 

The treatment of bipolar disorder is complex, and depends on the particular phase of illness. The mood stabilizers form the foundation of treatment. These include lithium and the anticonvulsant drugs, valproate, and carbamazepine (Bowden, 1998 McElroy and Keck, 2000 Post, 2000). Recently, lamoh igine has been found effective in some patients (Post, 2000). The goal of treatment with mood stabilizers is reduction of frequency and severity of episodes of depression and mania. 

The goal of therapy for bipolar disorder should be to elim- inate mood episodes, maximize adherence to therapy, improve the functioning of the patient, and limit adverse... 

The desired outcome for bipolar disorder is to alleviate or shorten the duration of an acute manic, hypomanic, or depressive episode, to maintain good functioning, and to prevent further cycles of mania or depression. The general principles and goals for the management of bipolar disorder are found in Table 68-5. 

Clients with bipolar disorders cannot be helped until they have been thoroughly assessed for appropriate medication. Once the need for medication is determined, the goal is to identify the appropriate medication and dosage. Clients with bipolar disorder, and for Aat matter any client with a serious psychiatric illness, should not be prescribed medication as the sole treatment intervention. Although major advances have been made in the field of psychotropic medication, clinical practice and the literature have always emphasized the multifaceted approach for multidimensional problems. It is important to remember that all mental illnesses impact on the biological, social, and psychological spheres of a client s life and functioning (Walsh, 1989). 

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