An Ever-Increasing Pharmacopoeia for the Management of Patients With Bipolar Disorder.

Bipolar disorder is a recurrent and relapsing mood disorder characterized by cycles of depressionand mania. This article addresses the treatment of patients with bipolar mania, which remains one ofthe most difficult challenges facing clinicians. Patients require safe and effective therapeutic approachesfor acute episodes of mania and depression, as well as chronic prophylaxis against futureepisodes. Monotherapeutic approaches are rarely effective, and combination approaches are associatedwith an increased risk of adverse events. Lithium is the only agent currently approved for thetreatment of both acute episodes of mania and maintenance therapy; however, it is associated with arelatively poor response rate, high relapse rate, and less-than-optimal side effect profile. Other recentapproaches have included several anticonvulsant agents, as well as conventional and atypical antipsychoticagents.