Conference Coverage
Bipolar affective disorder is twice as common among individuals with MS as it is in the general population. The disorder is characterized by grandiosity, elevated mood, irritability, and increased motor activity. No data are available about treating bipolar affective disorder in patients with MS, so neurologists must consult the psychiatric literature. “Patients respond well to mood-stabilizing medication such as lithium or valproic acid,” said Dr. Feinstein. “If your patients are psychotic, occasionally you have to introduce an antipsychotic agent as well.”
Between 9% and 13% of patients with MS have euphoria, an exaggerated feeling of mental and physical well-being. People with MS and euphoria tend to have significant brain atrophy and heavy lesion load, and no treatments for euphoria exist. Treating the disorder might be undesirable anyway, although it adds to the burden on the patient’s caregiver, said Dr. Feinstein.
—Erik Greb