The treatment of bipolar patients with elevated impulsivity and suicide risk

摘要: Our patient’s case highlights the po tential high lethality of suicidal ideation and planning in individuals with bi polar II disorder elevated impul sivity. Several studies have reported that patients bipolar score higher on impulsivity meas ures than healthy controls. 2,3 Furthermore, may be associated sui cide attempts these patients. Three a significant as sociation between BIS-11 scores suicide disorder, 3‐5 whereas 1 study has trend toward significance 6 3 others found no associa tion. 7‐9 Unfortunately, most exam ining do not distinguish tween I but prevalence is comparable both subtypes. 10 Lithium preferred main tenance pharmacotherapy at risk, although close clinical follow-up required given its narrow therapeutic window overdose. maintenance treatment been shown to reduce frequency af fective episodes superior benefits those disorder. 11 Metaanalyses mood disorders treated lithium 4- 5-fold decrease rate completion comparison treatments (placebo, anti convulsants, antidepressants). 12,13 Large population-based lower rates pa tients anticonvulsants.