Difference between revisions of "Bipolar Affective Disorder"

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==Acceptability at Recruitment==
+
==Condition==
QUALIFIED
 
  
==Acceptability at CT / Work-Up==
+
Bipolar affective disorder. Also known as manic depression.
QUALIFIED
 
  
 
==Individual at Risk==
 
==Individual at Risk==
Donor
 
  
==Explanation of Condition==
+
Donor / recipient
Psychiatric disorder characterised by alternating phases of hyperactive behaviour (mania) and severe depression.
 
  
==Guidance==
+
==Guidance at RECRUITMENT==
May be acceptable if not currently manic, or if condition adequately treated with medication or counseling. Disease must be stable for at least one year.
 
In addition, if donor is taking valproate or carbamazepine, it should be established that medication is well tolerated, with no significant effect on blood counts and liver function.
 
Donors taking lithium may donate by bone marrow only.
 
  
Ask the following questions:
+
MAY BE ACCEPTABLE if not currently manic, or if condition adequately treated with medication or counselling. The condition should have been stable for at least one year.
 +
 
 +
In addition, if donor is taking neuroleptics, valproate or carbemazepine, it should be established that medication is well tolerated, with no significant effect on blood counts and liver function. Ask the following questions:  
 +
 
 +
Can the donor work and travel?
 +
 
 +
Could the donor cope with a hospital stay if required to donate?
  
Can the donor work and travel?
 
Could the donor cope with a hospital stay if required to donate?
 
 
Could the donor cope with pressures involved with donating, as donation may be a stressful procedure for some individuals?  
 
Could the donor cope with pressures involved with donating, as donation may be a stressful procedure for some individuals?  
  
 
If the answer to these questions are yes, than accept.  
 
If the answer to these questions are yes, than accept.  
  
Refer to medical officer if necessary.
+
Donors taking lithium
 +
 
 +
Donors taking lithium may donate by BM only.
 +
 
 +
==Guidance at CT/WORK-UP==
 +
 
 +
MAY BE ACCEPTABLE if not currently manic, or if condition adequately treated with medication or counselling. The condition should have been stable for at least one year.
 +
 
 +
In addition, if donor is taking neuroleptics, valproate or carbemazepine, it should be established that medication is well tolerated, with no significant effect on blood counts and liver function. Ask the following questions:
 +
 
 +
Can the donor work and travel?
 +
 
 +
Could the donor cope with a hospital stay if required to donate?
 +
 
 +
Could the donor cope with pressures involved with donating, as donation may be a stressful procedure for some individuals?
 +
 
 +
If the answer to these questions are yes, than accept.
 +
 
 +
Donors taking lithium
 +
 
 +
Donors taking lithium may be able to donate by BM only.
 +
 
 +
==Justification for guidance==
 +
 
 +
The majority of donors with bipolar affective disorder will be able to donate. There is anecdotal evidence of donors with mental illness withdrawing from donation at the last minute, but this behaviour has also been seen in non-depressed donors and forms no basis for deferral.
 +
 
 +
There is some evidence than those who are in a manic phase may have an impaired capacity to undergo informed consent, and as such these donors should be deferred until the mania has resolved.
 +
 
 +
Lithium may enhance the effect of G-CSF, thus its use is a protocol exclusion for PBSC.
 +
 
 +
==References==
 +
 
 +
Misra S, Ganzini L. Capacity to consent to research among patients with bipolar disorder. J Affect Disord 2004; 80(2-3): 115-23.
 +
 
 +
Focosi, D., Azzara, A., Kast, R. E., Carulli, G. & Petrini, M. 2009. Lithium and hematology: established and proposed uses. J Leukoc Biol, 85, 20-8.  
 +
 
  
 
==Pseudonyms or Related Conditions==
 
==Pseudonyms or Related Conditions==

Revision as of 16:57, 9 June 2016

Condition

Bipolar affective disorder. Also known as manic depression.

Individual at Risk

Donor / recipient

Guidance at RECRUITMENT

MAY BE ACCEPTABLE if not currently manic, or if condition adequately treated with medication or counselling. The condition should have been stable for at least one year.

In addition, if donor is taking neuroleptics, valproate or carbemazepine, it should be established that medication is well tolerated, with no significant effect on blood counts and liver function. Ask the following questions:

Can the donor work and travel?

Could the donor cope with a hospital stay if required to donate?

Could the donor cope with pressures involved with donating, as donation may be a stressful procedure for some individuals?

If the answer to these questions are yes, than accept.

Donors taking lithium

Donors taking lithium may donate by BM only.

Guidance at CT/WORK-UP

MAY BE ACCEPTABLE if not currently manic, or if condition adequately treated with medication or counselling. The condition should have been stable for at least one year.

In addition, if donor is taking neuroleptics, valproate or carbemazepine, it should be established that medication is well tolerated, with no significant effect on blood counts and liver function. Ask the following questions:

Can the donor work and travel?

Could the donor cope with a hospital stay if required to donate?

Could the donor cope with pressures involved with donating, as donation may be a stressful procedure for some individuals?

If the answer to these questions are yes, than accept.

Donors taking lithium

Donors taking lithium may be able to donate by BM only.

Justification for guidance

The majority of donors with bipolar affective disorder will be able to donate. There is anecdotal evidence of donors with mental illness withdrawing from donation at the last minute, but this behaviour has also been seen in non-depressed donors and forms no basis for deferral.

There is some evidence than those who are in a manic phase may have an impaired capacity to undergo informed consent, and as such these donors should be deferred until the mania has resolved.

Lithium may enhance the effect of G-CSF, thus its use is a protocol exclusion for PBSC.

References

Misra S, Ganzini L. Capacity to consent to research among patients with bipolar disorder. J Affect Disord 2004; 80(2-3): 115-23.

Focosi, D., Azzara, A., Kast, R. E., Carulli, G. & Petrini, M. 2009. Lithium and hematology: established and proposed uses. J Leukoc Biol, 85, 20-8.


Pseudonyms or Related Conditions

Manic Depression

Manic Depressive Disorder

Bipolar Disorder

Version

Version 1, Edition 1

Date of Last Update

15th June 2012