The treatment of bipolar patients with elevated impulsivity and suicide risk

Abstract

Presents a case report of 22-year-old man with bipolar II disorder, who was referred for follow-up at the mood disorders clinic of a tertiary care center. He was first seen by a psychiatrist at age 20 when he had a 6-week episode of decreased need for sleep; increased energy; difficulty concentrating; and impulsive spending, including purchasing a new house. This patient's case highlights the potential high lethality of suicidal ideation and planning in individuals with bipolar II disorder and elevated impulsivity. Several studies have reported that patients with bipolar disorder score higher on impulsivity measures than healthy controls. Elevated impulsivity may increase the risk of suicidality in patients with bipolar disorder. Although there are limited data on the treatment of highly impulsive patients, there is evidence that lithium may reduce both impulsivity and suicidality in patients with bipolar disorder. Clinicians treating patients with bipolar disorder should be vigilant during assessment and followup for elevated impulsivity as part of a thorough suicide risk assessment and should consider lithium maintenance as a potential strategy. (PsycInfo Database Record (c) 2021 APA, all rights reserved)