Treating Bipolar Disorder in Primary Care: Diagnosis, Pharmacology, and Management

Heather Huang,1 Nicholas Nissen,2 Christopher T Lim,3 Jessica L Gören,2,4 Margaret Spottswood,5,6 Hsiang Huang2 1Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 2Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA; 3Department of Psychiatry, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA; 4Department of Pharmacy, Cambridge Health Alliance, Cambridge, MA, USA; 5Community Health Centers of Burlington, Burlington, VT, USA; 6Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USACorrespondence: Hsiang Huang, Department of Psychiatry, Cambridge Health Alliance, 1493 Cambridge St, Cambridge, MA, 02139, USA, Tel +1-206-414-8198, Email hhuang@cha.harvard.eduAbstract: Bipolar disorder is a chronic mental illness associated with early mortality, elevated risk of comorbid cardiovascular disease, enormous burden of disability, and large societal costs. Patients often seek treatment for symptoms of bipolar disorder in the primary care setting but are frequently misdiagnosed. This article provides primary care providers with an evidence-based approach to the screening, diagnosis, and pharmacological management of bipolar disorder. Guidance is also provided for helping patients connect with higher levels of specialty psychiatric care when clinically indicated.Keywords: bipolar disorder, mood disorders, integrated behavioral care, primary care mental health