Which pharmacologic treatment regimens are used in the treatment of bipolar affective disorder (manic-depressive illness)?

Updated: May 06, 2018
  • Author: Stephen Soreff, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

Appropriate medication depends on the stage of the bipolar disorder, or manic-depressive illness (MDI), the patient is experiencing. Thus, a number of drugs are indicated for an acute manic episode, primarily the antipsychotic agents, valproate, and benzodiazepines (eg, lorazepam, clonazepam). The choice of agent depends on the presence of symptoms such as psychotic symptoms, agitation, aggression, and sleep disturbance. (See the list of medications for bipolar disorder in Table 1, below.) For patients with bipolar disorder in the depressed phase, the Medscape Reference article Depression provides antidepressant guidelines.

Table 1. FDA-Approved Bipolar Treatment Regimens (Open Table in a new window)

Generic Name

Trade Name

Manic

Mixed

Maintenance

Depression

Valproate

Depakote

X

 

 

 

Carbamazepine extended release

Equetro

X

X

 

 

Lamotrigine

Lamictal

 

 

X

 

Lithium

 

X

 

X

 

Aripiprazole

Abilify

X

X

X

 

Ziprasidone

Geodon

X

X

 

 

Risperidone

Risperdal

X

X

 

 

Asenapine

Saphris

X

X

 

 

Quetiapine

Seroquel

X

 

 

X

Chlorpromazine

Thorazine

X

 

 

 

Cariprazine Vraylar X X    

Olanzapine

Zyprexa

X

X

X

 

Olanzapine/fluoxetine combination

Symbyax

 

 

 

X

Lurasidone Latuda       X

FDA = United States Food and Drug Administration.

Source:  Gutman DA, Nemeroff C.Medscape Education. Atypical antipsychotics in bipolar disorder.Available at: http://www.medscape.org/viewarticle/554128. Accessed: June 27, 2007. [81]


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