What are the medication treatment options for 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

Bauer and colleagues have suggested 2 approaches to treatment options in bipolar patients. [82] First, in a patient with bipolar depression who is not currently being treated with a mood-stabilizing agent (de novo depression, first or subsequent episode), options include quetiapine or olanzapine, with carbamazepine and lamotrigine as alternatives. [82] Antidepressants are options for short-term use, but it remains controversial as to whether it is better to administer them in combination with mood-stabilizing agents or as monotherapy. Second, if the patient is already optimally treated with a mood-stabilizing agent (appropriate dose, good compliance) such as lithium, an option would be lamotrigine. No evidence suggests additional benefit from antidepressants if a patient is already being treated with a mood stabilizer, but this often tried in practice. [82]


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