Short-term and long-term treatment
for bipolar patients: beyond the guidelines
by
Mendlewicz J, Souery D, Rivelli SK
Department of Psychiatry,
University Clinics of Brussels,
Erasme Hospital, Belgium.
jmendlew@ulb.ac.be
J Affect Disord 1999 Sep; 55(1):79-85

ABSTRACT

This clinical review considers the different symptomatic forms of bipolar disorders and the influence of the clinical subtype on treatment. Therapy is required both to manage the various types of acute episodes of mania or depression and to prevent recurrence. For the latter purpose, continuous long-term or even lifetime prophylaxis may be required, continuing on after control of the acute episode. In this context, the roles and potential side-effects of lithium, divalproex sodium and carbamazepine, alone and in combination, are summarized, along with the proper use of antipsychotic drugs. The selection of mood-stabilizing agent or drug combination depends on the clinical manifestations of bipolar disorder, family history and previous treatment history of the patient. Particular caution must be exercised in those with a history of antidepressant-induced switches; many such patients appear prone to course aggravation and even rapid-cycling and will often need combined mood-stabilizer combinations.

Mania
Lithium
Quetiapine
Divalproex
Gabapentin
Lamotrigine
Carbamazepine
Bipolar disorders
Drugs for bipolars
Valproate versus lithium

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