Bipolar Affective Disorder

Mood swings alternating between mania and depression, known as bipolar disorder, are more common in MS than in the general population. Bipolar disorder may occur as a disease symptom, or may occur in response to drug treatment, most commonly, steroids.

Management

Lithium, carbamazepine, and valproate are the most commonly used mood stabilizers, as well as gabapentin and lamotrigine. Data on the use of these drugs in MS is mostly anecdotal and large studies are lacking. Of note, lithium can produce increased urine output and so may be poorly tolerated by people with bladder dysfunction.

Screening for additional mental health issues such as depression should be considered.

Key Healthcare Professionals

• Family physician
• Neurologist
• Neuropsychiatrist