Table 2.

Differential Diagnosis of Bipolar Disorder^a

Secondary mania	Substance induced	Intoxication or use: alcohol, LSD, amphetamines/sympathomimetics, benzodiazepines, corticosteroids, isoniazid, levodopa, thyroxine, zidovudineWithdrawal: alcohol, benzodiazepines, β-blockers
	Metabolic	Hemodialysis, postoperative state, thyrotoxicosis, B12 deficiency, Cushing's syndrome
	Infectious	Influenza, encephalitis, HIV, neurosyphilis
	Neurologic	Neoplasm, complex partial seizure, Wilson's disease, Huntington's disease, multiple sclerosis, stroke
Secondary depression	Substance induced	Intoxication or use: opiates, benzodiazepines, anticonvulsants, alcohol, reserpineWithdrawal: cocaine, amphetamines/sympathomimetics
	Metabolic	Uremia, niacin deficiency (pellagra), B12 deficiency, anemia, hypothyroidism, Cushing's syndrome, Addison's disease, sleep apnea, heavy metal toxicity, paraneoplastic syndromes
	Infectious	Lyme disease, neurosyphilis, HIV, Behçet's syndrome, meningitis
	Neurologic/ cerebrovascular	Ischemia, stroke (especially left-sided), neoplasm, complex partial seizures, postictal state, normal pressure hydrocephalus, Parkinson's disease

^aBased on Stern et al.¹⁶