Management of Acute Mania

Bipolar disorder is a lifelong episodic condition characterized by mood swings between mania and depression. In the United States alone, approximately 4 million people are affected by this disorder. Pharmacologic treatment for acute manic episodes or as maintenance therapy includes lithium, valproate, carbamazepine, and typical antipsychotics. However, many patients fail to respond to these treatments due to lack of efficacy or production of side effects leading to patient noncompliance. Noncompliance with pharmacologic treatment is indeed a major risk factor in bipolar disorder patients and needs to be managed with ongoing education, psychotherapy, and a simplified but effective pharmacologic treatment regimen. Recently introduced novel antipsychotics show much promise as mood-stabilizing agents in bipolar patients, with minimal risk of treatment-emergent extrapyramidal symptoms and tardive dyskinesia. Nonetheless, further research is warranted to help clarify the role of novel antipsychotics in the treatment of bipolar disorder.