This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Educational Activity

Acute Treatment of Patients With Bipolar Mixed Episodes

Roger S. McIntyre, MD

Published: March 18, 2008

This CME activity is expired. For more CME activities, visit
Find more articles on this and other psychiatry and CNS topics:
The Journal of Clinical Psychiatry
The Primary Care Companion for CNS Disorders

Article Abstract

Managing bipolar mixed states should start by establishing a diagnosis, assessing for comorbidities, and clarifying targets for therapy. Differentiating between unipolar and bipolar disorder is important because these conditions have dissimilar efficacious pharmacotherapeutic options. To treat mixed states, atypical antipsychotics or divalproex have been shown to be effective, and antidepressants should generally be avoided. Because of the complexity of mixed episodes, monotherapy may be insufficient and patients may require combination treatment. As more medications become available in the treatment of bipolar disorder, algorithms can help clinicians make the appropriate treatment choices by offering recommendations for sequencing agents.

Some JCP and PCC articles are available in PDF format only. Please click the PDF link at the top of this page to access the full text.

Related Articles

Volume: 69

Quick Links: