Bipolar I with "Dysphoric Hypomania". Which Monotherapy not Efficacious?

Q. Bipolar I Disorder patient presented with "Dysphoric Hypomania". Which of the following medication should not be your first choice as monotherapy?

(a) Valproate
(b) Risperidone
(c) Aripiprazole
(d) Quetiapine
(e) Ziprasidone

Note: Lithium is other medication with less robust response in presence of mixed or dysphoric hypomania or mania. Which is the second medications from above list ??

Everyone is encouraged to try. Interesting & important questions for residents, as we evaluate pt with Bipolar disorder almost on a daily basis.

Admin wrote:
Q. Bipolar I Disorder patient presented with "Dysphoric Hypomania". Which of the following medication should not be your first choice as monotherapy?

(a) Valproate
(b) Risperidone
(c) Aripiprazole
(d) Quetiapine
(e) Ziprasidone

Note: Lithium is other medication with less robust response in presence of mixed or dysphoric hypomania or mania. Which is the second medications from above list ??

Everyone is encouraged to try. Interesting & important questions for residents, as we evaluate pt with Bipolar disorder almost on a daily basis.

Answer: (d) Quetiapine.

If a Bipolar pt presents with Mania ---> First question is ---> Is this Euphoric vs Mixed --->
(a) Euphoric --> Lithium, Depakote, Risperidone, Quetiapine, Aripiprazole, Ziprasidone
(b) Mixed ---> Depakote, Risperidone, Aripiprazole, Ziprasidone