Category Archives: Bipolar Disorder

Management of Bipolar Disorder

Antipsychotics are frequently used in the treatment of bipolar disorder. Most patients started on antipsychotics as adjunctive treatment for manic episodes continue these agents beyond 6 months, even in the absence of conclusive data on the long-term efficacy of most antipsychotics in maintenance treatment. Typical antipsychotics are effective antimanic agents but appear less effective than… Read More »

Bipolar Depression

The notion that bipolar and unipolar depression might be distinct illnesses was first proposed in the middle of the 20th century. Before this time, manic-depressive illness was considered to encompass a broad range of psychopathology, including recurrent unipolar depression. We now recognize that there are substantial differences between depression arising from bipolar disorder and with… Read More »

Bipolar Depression: Treatment Acute Pharmacotherapy

Lithium For many years, lithium was considered to be the standard treatment for bipolar depression. Improvement rates of 80% have been reported in nine placebo-controlled studies, conducted mostly in the 1970s. Response rates for lithium were equivalent to those for tricyclic antidepressants (tricyclic antidepressants). A recent study of outpatients with bipolar depression compared the efficacy… Read More »

Bipolar Depression: Antidepressants

Tricyclic Antidepressants Literature is sparse on controlled studies of tricyclic antidepressants for bipolar depression. Tricyclic antidepressants are more effective in the treatment of unipolar depression than in bipolar depression. The risk of switching patients from bipolar depression to mania and of shortening cycle lengths makes tricyclic antidepressants unattractive choices for the treatment of bipolar depression.… Read More »

Information about Bipolar Disorder for Patients and Families

Bipolar disorder, also called manic-depressive disorder, is a recurrent illness in which the individual’s mood cycles between depression and mania with periods of normality. The illness is a mood disorder. The individual’s moods may swing from manic euphoria, with boundless energy in pursuit of grandiose plans, to depths of depression, with feelings of despair and… Read More »

Drug Treatment Of Mania

When assessing the patient, enquiries should be made about their recent compliance with medication, as sudden discontinuation of lithium may have triggered the manic episode. It is usually prudent to cease any antidepressant medication they may have been taking. A physical examination and tests of the blood and urine should, if possible, precede drug treatment… Read More »

Treatment of Mania: Monotherapy or Combination Treatment

Antipsychotic-Resistant Mania A proportion of manic patients show only partial improvement or initial improvement followed by partial relapse with antipsychotic drugs. There is little evidence that increasing the dose will produce further improvement. Clozapine may prove to be useful in resistant mania as in resistant schizophrenia. However, at the present time, the main alternatives or… Read More »

Drug Treatment Of Mania: Assessing the Evidence

To prove that a drug is efficacious in a psychiatric condition, it is essential to show that it is superior to placebo, by conducting randomized double-blind placebo-controlled trials. The challenges of conducting such trials in mania have only been met in recent years, in the course of developing novel anticonvulsant and atypical antipsychotic treatments. These… Read More »

Combination Therapy in Bipolar Disorder

Monotherapy for bipolar disorder is well established as both acute and prophylactic treatment, the most familiar drugs used in these roles being lithium, sodium valproate, and carbamazepine. The choice of agent can be guided at least in part by the subtype of bipolar disorder, for instance, valproate possibly being more efficacious in rapid cycling illness… Read More »