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(p. 237) Pharmacological Treatments for Bipolar Disorder 

(p. 237) Pharmacological Treatments for Bipolar Disorder
(p. 237) Pharmacological Treatments for Bipolar Disorder

Paul E. Keck

and Susan L. McElroy

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date: 27 November 2020

The majority of clinical trials in patients with bipolar disorders have been conducted in groups with bipolar I illness, although a few trials have included patients with bipolar II disorder. Pharmacological management of bipolar disorder involves the treatment of acute manic, hypomanic, mixed, and depressive episodes, as well as the prevention of further episodes and subsyndromal symptoms. Lithium, divalproex, carbamazepine, haloperidol, risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, and asenapine have demonstrated efficacy in the treatment of acute mania in randomized controlled (type 1) trials. Although the pharmacological treatment of acute bipolar depression remains understudied, data from randomized controlled trials indicate that lithium, olanzapine, olanzapine-fluoxetine, quetiapine, lurasidone, tricyclics, monoamine oxidase inhibitors, and fluoxetine have efficacy in this phase of the illness. Lithium, lamotrigine, olanzapine, aripiprazole, quetiapine, and risperidone (long-acting, injectable) have been shown to have efficacy in relapse prevention. Less extensive data suggest that divalproex and carbamazepine are also efficacious for prevention.

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