The “Mania” Event: Distinguishing Between and Treating BPI and BPII
Presented by Roger S. McIntyre, MD, FRCPC
Friday, March 31, 2023
At the 2023 NEI Synapse, Roger S. McIntyre, MD, FRCPC presented a lecture on diagnosing and treating bipolar spectrum disorders, with an emphasis on differentiating bipolar I disorder (BPI) and bipolar II disorder (BPII). Bipolar disorders are associated with polymorbidity and a higher risk of suicide than the general population. Thus, their prompt diagnosis and treatment are essential to maximize patient outcomes.
In his presentation, Dr. Roger McIntyre first delved into the diagnostic criteria, epidemiology, and phenomenology of bipolar spectrum disorders. Some key differences in the clinical features of BPII include a greater number of psychiatric comorbidities and risk for suicide attempt and completion, compared to BPI. Conversely, BPI is associated with the presence of psychosis (in 50% of cases), hospitalization due to mania, and worse global cognition, compared to BPII. Particularly relevant to treatment is that patients with BPII have a greater proportion of total time ill accounted for by depression (82.4%) compared to patients with BPI (69.6%). Pharmacological treatment options may be more limited for BPII than BPI, particularly for episodes of depression. Dr. McIntyre completed his presentation by reviewing FDA-approved medications (Table 1) and the evidence supporting other treatment options, including the use of antidepressant monotherapy in bipolar I depression versus bipolar II depression.
Table 1. FDA-Approved Medications for Bipolar Depression
|
Bipolar I depression |
Bipolar II depression |
| Lumateperone |
✓ |
✓ |
| Quetiapine |
✓ |
✓ |
| Cariprazine |
✓ |
|
| Lurasidone |
✓ |
|
| Olanzapine-fluoxetine |
✓ |
|
Source:
Roger S. McIntyre, MD, FRCPC. The “Mania” Event: Distinguishing Between and Treating BPI and BPII. Presented March 31 at 2023 NEI Synapse, Nashville, TN.
To Learn More: The recording of this presentation, as well as all of the other presentations from the 2023 NEI Synapse, will be available as Encore Presentations for NEI Members.