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Pharmacological Management of Manic Episodes

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Managing Bipolar Disorder in Clinical Practice

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Abstract

The goals of treatment of an acute manic or mixed episode are to alleviate symptoms and allow a return to usual levels of psychosocial functioning. Achieving rapid control of agitation, aggression, poor judgement, and impulsivity is particularly important to ensure the safety of patients and those around them and to allow the establishment of a therapeutic alliance.

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References

  1. Yatham LN, Kennedy SH, O’Donovan C; Canadian Network for Mood and Anxiety Treatments. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord. 2005;7(suppl 3):5-69.

    Google Scholar 

  2. Fountoulakis KN, Vieta E, Sanchez-Moreno J, et al. Treatment guidelines for bipolar disorder: a critical review. J Affect Disord. 2005;86:1-10.

    Google Scholar 

  3. Yatham LN, Kennedy SH, Schaffer A, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009. Bipolar Disord 2009; 11:225-255.

    Google Scholar 

  4. Goodwin GM; Consensus Group of the British Association for Psychopharmacology. Evidence based guidelines for treating bipolar disorder: revised second edition— recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2009;23:346-388.

    Google Scholar 

  5. Grunze H, Vieta E, Goodwin GM, et al. WFSBP Task Force on Treatment Guidelines for Bipolar Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders.: update 2009 on the treatment of acute mania. World J Biol Psychiatry. 2009;10:85-116.

    Google Scholar 

  6. Bowden CL. Key treatment studies of lithium in manic-depressive illness: efficacy and side effects. J Clin Psychiatry. 1998;59(suppl 6):13-19.

    Google Scholar 

  7. Swann AC, Bowden CL, Morris D, et al. Depression during mania. Treatment response to lithium or divalproex. Arch Gen Psychiatry. 1997;54:37-42.

    Google Scholar 

  8. Goodwin GM. Recurrence of mania after lithium withdrawal. Implications for the use of lithium in the treatment of bipolar affective disorder. Br J Psychiatry. 1994;164:52.

    Google Scholar 

  9. Bowden CL, Grunze H, Mullen J, et al. A randomized, double-blind, placebo-controlled efficacy and safety study of quetiapine or lithium as monotherapy for mania in bipolar disorder. J Clin Psychiatry. 2005;66:111-121.

    Google Scholar 

  10. Keck PE, Orsulak PJ, Cutler AJ, et al; the CN-138-35 Study Group. Aripiprazole monotherapy in the treatment of acute bipolar I mania: a randomized, double-blind, placebo- and lithium-controlled study. J Affect Disord. 2009;112:36-49.

    Google Scholar 

  11. Bowden CL, Brugger AM, Swann AC, et al. Efficacy of divalproex versus lithium and placebo in the treatment of mania. JAMA. 1994;271:918-924.

    Google Scholar 

  12. Sachs GS, Grossman F, Ghaemi SN, et al. Combination of a mood stabilizer with risperidone or haloperidol for treatment of acute mania: a double-blind, placebo-controlled comparison of efficacy and safety. Am J Psychiatry. 2002;159:1146-1154.

    Google Scholar 

  13. Tohen M, Chengappa KN, Suppes T, et al. Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy. Arch Gen Psychiatry. 2002;59:62-69.

    Google Scholar 

  14. Sachs G, Chengappa KN, Suppes T et al. Quetiapine with lithium or divalproex for the treatment of bipolar mania: a randomized, double-blind, placebo-controlled study. Bipolar Disord. 2004; 6:213-223.

    Google Scholar 

  15. Vieta E, T’joen C, McQuade RD et al. Efficacy of adjunctive aripiprazole to either valproate or lithium in bipolar mania patients partially nonresponsive to valproate/lithium monotherapy: a placebo-controlled study. Am J Psychiatry. 2008; 165:1316-1325.

    Google Scholar 

  16. Garfinkel PE, Stancer HC, Persad E. A comparison of haloperidol, lithium carbonate, and their combination in the treatment of mania. J Affect Disord. 1980;2:279-288.

    Google Scholar 

  17. Johnstone EC, Crow TJ, Frith CD, et al. The Northwick Park ‘functional’ psychosis study: diagnosis and treatment response. Lancet. 1988;2:119-125.

    Google Scholar 

  18. Yatham LN, Grossman F, Augustyns I, et al. Mood stabilisers plus risperidone or placebo in the treatment of acute mania: international, double-blind, randomised controlled trial. Br J Psychiatry. 2003;182:141-147.

    Google Scholar 

  19. Yatham LN, Vieta E, Young AH, et al. A double blind, randomized, placebo-controlled trial of quetiapine as an add-on therapy to lithium or divalproex for the treatment of bipolar mania. Int Clin Psychopharmacol. 2007; 22:212-220.

    Google Scholar 

  20. Weisler R, Dunn J, English P. Ziprasidone in adjunctive treatment of acute bipolar mania: randomized, double-blind, placebo-controlled trial. 16th European College of Neuropsychopharmachology Congress, Prague, Czech Republic, September 20–24, 2003.

    Google Scholar 

  21. Freeman MP, Stoll AL. Mood stabilizer combinations: a review of safety and efficacy. Am J Psychiatry. 1998;155:12-21.

    Google Scholar 

  22. Pope HG Jr, McElroy SL, Keck PE, et al. Valproate in treatment of acute mania. A placebo controlled study. Arch Gen Psychiatry. 1991;48:62-68.

    Google Scholar 

  23. Bowden C, Gogus A, Grunze H, et al. A 12-week, open, randomized trial comparing sodium valproate to lithium in patients with bipolar I disorder suffering from a manic episode. Int Clin Psychopharmacol. 2008; 23:254-262.

    Google Scholar 

  24. Weisler RH, Kalali AH, Ketter TA. A multicenter, randomized, double-blind, placebo-controlled trial of extended-release carbamazepine capsules as monotherapy for bipolar disorder patients with manic or mixed episodes. J Clin Psychiatry. 2004;65:478-484.

    Google Scholar 

  25. Weisler RH, Keck PE Jr, Swann AC, et al. Extended-release carbamazepine capsules as monotherapy for acute mania in bipolar disorder: a multicenter, randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2005;66:323-330.

    Google Scholar 

  26. Lerer B, Moore N, Meyendorff E, et al. Carbamazepine versus lithium in mania: a double-blind study. J Clin Psychiatry. 1987;48:89-93.

    Google Scholar 

  27. Small JG, Klapper MH, Milstein V, et al. Carbamazepine compared with lithium in the treatment of mania. Arch Gen Psychiatry. 1991;48:915-921.

    Google Scholar 

  28. Small JG, Klapper MH, Marhenke JD, et al. Lithium combined with carbamazepine or haloperidol in the treatment of mania. Psychopharmacol Bull. 1995;31:265-272.

    Google Scholar 

  29. Tohen M, Bowden CL, Smulevich AB, et al. Olanzapine plus carbamazepine v. carbamazepine alone in treating manic episodes. Br J Psychiatry. 2008;192:135-143.

    Google Scholar 

  30. Vieta E. The role of third-generation anticonvulsants in the treatment of bipolar disorder. Clin Neuropsychiatry. 2004;1:159-164.

    Google Scholar 

  31. Popova E, Leighton C, Bernabarre A, et al. Oxcarbazepine in the treatment of bipolar and schizoaffective disorders. Expert Rev Neurother. 2007;7:617-626.

    Google Scholar 

  32. Goldsmith DR, Wagstaff AJ, Ibbotson T, et al. Lamotrigine: a review of its use in bipolar disorder. Drugs. 2003;63:2029-2050.

    Google Scholar 

  33. Pande AC, Crockatt JG, Janney CA, et al. Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group. Bipolar Disord. 2000;2(3 Pt 2):249-255.

    Google Scholar 

  34. Kushner SF, Khan A, Lane R, et al. Topiramate monotherapy in the management of acute mania: results of four double-blind placebo-controlled trials. Bipolar Disord. 2006;8:15-27.

    Google Scholar 

  35. Klein DF, Oaks G. Importance of psychiatric diagnosis in prediction of clinical drug effect. Arch Gen Psychiatry. 1967;16:118-126.

    Google Scholar 

  36. Johnstone EC, Crow TJ, Frith CD, et al. The Northwick Park ‘functional’ psychosis study: diagnosis and treatment response. Lancet. 1988;2:119-125.

    Google Scholar 

  37. Tohen M, Goldberg JF, Gonzalez-Pinto Arrillaga AM, et al. A 12-week, double-blind comparison of olanzapine vs haloperidol in the treatment of acute mania. Arch Gen Psychiatry. 2003;60:1218-1226.

    Google Scholar 

  38. Smulevich AB, Khanna S, Eerdekens M, et al. Acute and continuation risperidone monotherapy in bipolar mania: a 3-week placebocontrolled trial followed by a 9-week double-blind trial of risperidone and haloperidol. Eur Neuropsychopharmacol. 2005;15:75-84.

    Google Scholar 

  39. McIntyre RS, Brecher M, Paulsson B, et al. Quetiapine or haloperidol as monotherapy for bipolar mania: a 12-week, double-blind, randomised, parallel-group, placebo-controlled trial. Eur Neuropsychopharmacol. 2005;15:573-585.

    Google Scholar 

  40. Vieta E, Ramey T, Keller D, et al. Ziprasidone in the treatment of acute mania: 12-week placebo-controlled, haloperidol-referenced study. J Psychopharmacol. 2010;24:547-558.

    Google Scholar 

  41. Young AH, Oren DA, Lowy A, et al. Aripiprazole monotherapy in acute mania: 12-week, randomised placebo- and haloperidol-controlled study. Br J Psychiatry. 2009;194:40-48.

    Google Scholar 

  42. Vieta E, Bourin M, Sanchez R, et al. Effectiveness of aripiprazole versus haloperidol in acute bipolar mania: double-blind, randomised, comparative 12-week trial. Br J Psychiatry. 2005;187:235-242.

    Google Scholar 

  43. Janicak PG, Newman RH, Davis JM. Advances in the treatment of mania and related disorders: a reappraisal. Psychiatr Ann. 1992;22:92-103.

    Google Scholar 

  44. Prien RF, Caffey EM, Klett CJ. Comparison of lithium carbonate and chlorpromazine in the treatment of mania. Arch Gen Psychiatry. 1972;26:146-153.

    Google Scholar 

  45. Tohen M, Sanger TM, McElroy SL, et al. Olanzapine versus placebo in the treatment of acute mania. Am J Psychiatry. 1999;15:702-709.

    Google Scholar 

  46. Tohen M, Jacobs TG, Grundy SL, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2000;57:841-849.

    Google Scholar 

  47. Baldessarini RJ, Hennen J, Wilson M, et al. Olanzapine versus placebo in acute mania: treatment responses in subgroups. J Clin Psychopharmacol. 2003;23:370-376.

    Google Scholar 

  48. Sanger TM, Tohen M, Vieta E, et al. Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling. J Affect Disord. 2003;73:155-161.

    Google Scholar 

  49. Vieta E. Divalproex versus olanzapine in mania. J Clin Psychiatry. 2003;64:1266.

    Google Scholar 

  50. Zajecka JM, Weisler R, Sachs G, et al. A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. J Clin Psychiatry. 2002;63:1148-1155.

    Google Scholar 

  51. Tohen M, Baker RW, Altshuler LL, et al. Olanzapine versus divalproex in the treatment of acute mania. Am J Psychiatry. 2002;159:1011-1017.

    Google Scholar 

  52. Meehan K, Zhang F, David S, et al. A double-blind, randomized comparison of the efficacy and safety of intramuscular injections of olanzapine, lorazepam, or placebo in treating acutely agitated patients diagnosed with bipolar mania. J Clin Psychopharmacol. 2001;21:389-397.

    Google Scholar 

  53. Hirschfeld RM, Keck PE Jr, Kramer M, et al. Rapid antimanic effect of risperidone monotherapy: a 3-week multicenter, double-blind, placebo-controlled trial. Am J Psychiatry. 2004;161:1057-1065.

    Google Scholar 

  54. Khanna S, Vieta E, Lyons B, et al. Risperidone in the treatment of acute bipolar mania: double-blind, placebo-controlled study. Br J Psychiatry. 2005;187:229-234.

    Google Scholar 

  55. Keck PE Jr, Versiani M, Potkin S, et al; Zipradisone in Mania Study Group. Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double-blind, randomized trial. Am J Psychiatry. 2003;160:741-748.

    Google Scholar 

  56. Potkin SG, Keck PE Jr, Segal S, et al. Ziprasidone in acute bipolar mania: a 21-day randomized, double-blind, placebo-controlled replication trial. J Clin Psychopharmacol. 2005;25:301-310.

    Google Scholar 

  57. Keck PE Jr, Marcus R, Tourkodimitris S, et al. A placebo-controlled, double-blind study of the efficacy and safety of aripiprazole in patients with acute bipolar mania. Am J Psychiatry. 2003;160:1651-1658.

    Google Scholar 

  58. Sachs G, Sanchez R, Marcus R, et al. Aripiprazole in the treatment of acute manic or mixed episodes in patients with bipolar I disorder: a 3-week placebo-controlled study. J Psychopharmacol. 2006;20:536-546.

    Google Scholar 

  59. Garcia-Amador M, Pacchiarotti I, Valenti M et al. Role of aripiprazole in treating mood disorders. Expert Rev Neurother. 2006;6:1777-1783.

    Google Scholar 

  60. Vieta E, Franco C. Advances in the treatment of mania: aripiprazole. Actas Esp Psiquiatr. 2008;36:158-164.

    Google Scholar 

  61. Vieta E, Mullen J, Brecher M, et al. Quetiapine monotherapy for mania associated with bipolar disorder: combined analysis of two international, double-blind, randomised, placebo-controlled studies. Curr Med Res Opin. 2005;21:923-934.

    Google Scholar 

  62. Vieta E, Goldberg JF, Mullen J, et al. Quetiapine in the treatment of acute mania: target dose for efficacious treatment. J Affect Disord. 2007;100(suppl 1):S23-S31.

    Google Scholar 

  63. Cutler AJ, Datto C, Nordenhem A, et al. Extended-release quetiapine as monotherapy for the treatment of adults with acute mania: a randomized, double-blind, 3-week trial. Clin Ther. 2011;33:1643-1658.

    Google Scholar 

  64. Vieta E, Nuamah IF, Lim P. A randomized, placebo- and active-controlled study of paliperidone extended release for the treatment of acute manic and mixed episodes of bipolar I disorder. Bipolar Disord. 2010;12:230-243.

    Google Scholar 

  65. McIntyre RS, Cohen M, Zhao J, et al. A 3-week randomized, placebo-controlled trial of asenapine in the treatment of acute mania in bipolar mania and mixed states. Bipolar Disord. 2009;11:673-686.

    Google Scholar 

  66. McIntyre RS, Cohen M, Zhao J, et al. Asenapine in the treatment of acute mania in bipolar I disorder: a randomized, double-blind, placebo-controlled trial. J Affect Disord. 2010;122:27-38.

    Google Scholar 

  67. McIntyre RS, Cohen M, Zhao J, et al. Asenapine versus olanzapine in acute mania: a double-blind extension study. Bipolar Disord. 2009;11:815-826.

    Google Scholar 

  68. Szegedi A, Calabrese JR, Stet L, et al; the Apollo Study Group. Asenapine as adjunctive treatment for acute mania associated with bipolar disorder: results of a 12-week core study and 40-week extension. J Clin Psychopharmacol. 2012;32:46-55.

    Google Scholar 

  69. Vieta E, Ros S, Goikolea JM, et al. An open-label study of amisulpride in the treatment of mania. J Clin Psychiatry. 2005;66:575-578.

    Google Scholar 

  70. Thomas P, Vieta E; for the SOLMANIA study group. Amisulpride plus valproate vs haloperidol plus valproate in the treatment of acute mania of bipolar I patients: a multicenter, open-label, randomized, comparative trial. Neuropsychiatr Dis Treat. 2008; 4:675-686.

    Google Scholar 

  71. Vieta E, Panicali F, Goetz I, et al; EMBLEM Advisory Board. Olanzapine monotherapy and olanzapine combination therapy in the treatment of mania: 12-week results from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) observational study. J Affect Disord. 2008;106:63-72.

    Google Scholar 

  72. Bradwejn J, Shriqui C, Koszycki D, et al. Double-blind comparison of the effects of clonazepam and lorazepam in acute mania. J Clin Psychopharmacol. 1990;10:403-408.

    Google Scholar 

  73. Chouinard G, Annabel L, Turnier L, et al. A double-blind randomized clinical trial of rapid tranquilization with i.m. clonazepam and i.m. haloperidol in agitated psychotic patients with manic symptoms. Can J Psychiatry. 1993;38:S114-S121.

    Google Scholar 

  74. Vieta E, Phillips ML. Deconstructing bipolar disorder: a critical review of its diagnostic validity and a proposal for DSM-V and ICD-11. Schizophr Bull. 2007;33:886-892.

    Google Scholar 

  75. Toni C, Perugi G, Mata B, et al. Is mood-incongruent manic psychosis a distinct subtype? Eur Arch Psychiatry Clin Neurosci. 2001;251:12-17.

    Google Scholar 

  76. Swann A, Bowden C, Calabrese J, et al. Pattern of response to divalproex, lithium, or placebo in four naturalistic subtypes of mania. Neuropsychopharmacology. 2002;26:530-536.

    Google Scholar 

  77. McElroy SL, Keck PE, Stanton SP, et al. A randomized comparison of divalproex oral loading versus haloperidol in the initial treatment of acute psychotic mania. J Clin Psychiatry. 1996;57:142-146.

    Google Scholar 

  78. Perlis RH, Baker RW, Zarate CA Jr, et al. Olanzapine versus risperidone in the treatment of manic or mixed states in bipolar I disorder: a randomized, double-blind trial. J Clin Psychiatry. 2006;67:1747-1753.

    Google Scholar 

  79. Suppes T, Dennehy EB, Hirschfeld RM, et al; Texas Consensus Conference Panel on Medication Treatment of Bipolar Disorder. The Texas implementation of medication algorithms: update to the algorithms for treatment of bipolar I disorder. J Clin Psychiatry. 2005;66:870-886.

    Google Scholar 

  80. Weller E, Danielyan A, Weller R. Somatic treatment of bipolar disorder in children and adolescents. Psychiatr Clin North Am. 2004;27:155-178.

    Google Scholar 

  81. Geller B, Cooper T, Sun K, et al. Double-blind and placebo- controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry. 1998;37:171-178.

    Google Scholar 

  82. Rajeev J, Srinath S, Girimaji S, et al. A systematic chart review of the naturalistic course and treatment of early-onset bipolar disorder in a child and adolescent psychiatry center. Compr Psychiatry. 2004;45:148-154.

    Google Scholar 

  83. Kowatch R, Suppes T, Carmody T, et al. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2000;39:713-720.

    Google Scholar 

  84. Wagner K, Weller E, Carlson G, et al. An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2002;41:1224-1230.

    Google Scholar 

  85. Azorin JM, Findling RL. Valproate use in children and adolescents with bipolar disorder. CNS Drugs. 2007;21:1019-1033.

    Google Scholar 

  86. DelBello M, Schwiers M, Rosenberg H, et al. A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2002; 41:1216-1223.

    Google Scholar 

  87. DeBello MP, Kowatch RA, Adler CM, et al. A double-blind randomized pilot study comparing quetiapine and divalproex for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2006;45:305-313.

    Google Scholar 

  88. Wagner KD, Kowatch RA, Emslie GJ et al. A double-blind, randomized, placebo-controlled trial of oxcarbazepine in the treatment of bipolar disorder in children and adolescents. Am J Psychiatry. 2006;163:1179-1186.

    Google Scholar 

  89. Tohen M, Kryzhanovskaya L, Carlson G, et al. Olanzapine versus placebo in the treatment of adolescents with bipolar mania. Am J Psychiatry. 2007;164:1547-1556.

    Google Scholar 

  90. Haas M, DelBello MP, Pandina G, et al. Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled study. Bipolar Disord. 2009;11:687-700.

    Google Scholar 

  91. Sajatovic M, Coconcea N, Ignacio RV, et al. Aripiprazole therapy in 20 older adults with bipolar disorder: a 12-week, open-label trial. J Clin Psychiatry. 2008;69:41-46.

    Google Scholar 

  92. Kowatch RA, Fristad M, Birmaher B, et al. Treatment guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005;44:213-235.

    Google Scholar 

  93. McClellan J, Kowatch R, Findling RL, et al; Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2007;46:107-125.

    Google Scholar 

  94. Popovic D, Reinares M, Amann B, et al. Number needed to treat analyses of drugs used for maintenance treatment of bipolar disorder. Psychopharmacology (Berl). 2011;213:657-667.

    Google Scholar 

  95. Woodward TC, Tafesse E, Quon P, et al. Cost effectiveness of adjunctive quetiapine fumarate extended-release tablets with mood stabilizers in the maintenance treatment of bipolar I disorder. Pharmacoeconomics. 2010;28:751-764.

    Google Scholar 

  96. Grunze H, Kasper S, Goodwin G, et al. WFSBP Task Force on Treatment Guidelines for Bipolar Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders. Part III: maintenance treatment. World J Biol Psychiatry. 2004;5:120-135.

    Google Scholar 

  97. Burgess S, Geddes J, Hawton K, et al. Lithium for maintenance treatment of mood disorders. Cochrane Database Syst Rev. 2001;(3):CD003013.

    Google Scholar 

  98. Davis JM, Janicak PG, Hogan DM. Mood stabilizers in the prevention of recurrent affective disorders: a meta-analysis. Acta Psychiatr Scand. 1999;100:406-417.

    Google Scholar 

  99. Geddes JR, Burgess S, Hawton K, et al. Long-term lithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials. Am J Psychiatry. 2004;161:217-222.

    Google Scholar 

  100. Calabrese J, Bowden C, Sachs G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. J Clin Psychiatry. 2003;64:1013-1024.

    Google Scholar 

  101. Bowden C, Calabrese J, Sachs G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry. 2003;60:392-400.

    Google Scholar 

  102. Nivoli AMA, Murru A, Vieta E. Lithium: still a cornerstone in the long-term treatment of bipolar disorder? Neuropsychobiology. 2010; 62:27-35.

    Google Scholar 

  103. Goodwin FK, Fireman B, Simon GE, et al. Suicide risk in bipolar disorder during treatment with lithium and divalproex. JAMA. 2003;290:1467-1473.

    Google Scholar 

  104. Abou-Saleh MT, Coppen A. Who responds to prophylactic lithium? J Affect Disord. 1986;10:115-125.

    Google Scholar 

  105. Bowden C, Calabrese J, McElroy S, et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry. 2000;57:481-489.

    Google Scholar 

  106. Calabrese J, Shelton M, Rapport D, et al. A 20-month, double-blind, maintenance trial of lithium versus divalproex in rapid-cycling bipolar disorder. Am J Psychiatry. 2005;162:2152-2161.

    Google Scholar 

  107. Tohen M, Ketter T, Zarate C, et al. Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. Am J Psychiatry. 2003;160:1263-1271.

    Google Scholar 

  108. The BALANCE Investigators and Collaborators. Lithium plus valproate combination therapy versus monotherapy for relapse presentation in bipolar I disorder (BALANCE): a randomised open-label trial. Lancet. 2010;375:385-395.

    Google Scholar 

  109. Okuma T, Inanaga K, Otsuki S, et al. A preliminary double-blind study on the efficacy of carbamazepine in prophylaxis of manic-depressive illness. Psychopharmacology (Berl). 1981;73:95-96.

    Google Scholar 

  110. Dardennes R, Even C, Bange F, et al. Comparison of carbamazepine and lithium in the prophylaxis of bipolar disorders. A meta-analysis. Br J Psychiatry. 1995;166:378-381.

    Google Scholar 

  111. Greil W, Ludwig-Mayerhofer W, Erazo N, et al. Lithium versus carbamazepine in the maintenance treatment of bipolar disorders-a randomised study. J Affective Disord. 1997;43:151-161.

    Google Scholar 

  112. Greil W, Kleindienst N, Erazo N, et al. Differential response to lithium and carbamazepine in the prophylaxis of bipolar disorder. J Clin Psychopharmacol. 1998;18:455-460.

    Google Scholar 

  113. Hartong EG, Moleman P, Hoogduin CA, et al. Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients. J Clin Psychiatry. 2003;64:144-151.

    Google Scholar 

  114. Vieta E, Cruz N, Garcia-Campayo J, et al. A double-blind, randomized, placebo-controlled prophylaxis trial of oxcarbazepine as adjunctive treatment to lithium in the long-term treatment of bipolar I and II disorder. Int J Neuropsychopharmacol. 2008;11:445-452.

    Google Scholar 

  115. Vieta E, Manuel Goikolea J, Martinez-Aran A, et al. A double-blind, randomized, placebo-controlled, prophylaxis study of adjunctive gabapentin for bipolar disorder. J Clin Psychiatry. 2006;67:473-477.

    Google Scholar 

  116. Tohen M, Bowden C, Calabrese J, et al. Olanzapine’s efficacy for relapse prevention in bipolar disorder: A randomized double-blind controlled 12-month clinical trial. World J Biol Psychiatry. 2004;5:51.

    Google Scholar 

  117. Tohen M, Calabrese JR, Sachs GS, et al. Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine. Am J Psychiatry. 2006;163:247-256.

    Google Scholar 

  118. Tohen M, Greil W, Calabrese JR, et al. Olanzapine versus lithium in the maintenance treatment of bipolar disorder: a 12-month, randomized, double-blind, controlled clinical trial. Am J Psychiatry. 2005;162:1281-1290.

    Google Scholar 

  119. Keck PE Jr, Calabrese JR, McQuade RD, et al. A randomized, double-blind, placebo-controlled 26-week trial of aripiprazole in recently manic patients with bipolar I disorder. J Clin Psychiatry. 2006;67:626-637.

    Google Scholar 

  120. Keck PE Jr, Calabrese JR, McIntyre RS, et al. Aripiprazole monotherapy for maintenance therapy in bipolar I disorder: a 100-week, double-blind study versus placebo. J Clin Psychiatry. 2007;68:1480-1491.

    Google Scholar 

  121. Vieta E, Parramon G, Padrell E, et al. Quetiapine in the treatment of rapid cycling bipolar disorder. Bipolar Disord. 2002;4:335-340.

    Google Scholar 

  122. Vieta E. Mood stabilization in the treatment of bipolar disorder: focus on quetiapine. Hum Psychopharmacol. 2005;20:225-236.

    Google Scholar 

  123. Vieta E, Suppes T, Eggens I, et al. Efficacy and safety of quetiapine in combination with lithium or divalproex for maintenance of patients with bipolar I disorder (International trial 126). J Affect Disord. 2008;109:251-263.

    Google Scholar 

  124. Suppes T, Vieta E, Liu S, et al; Trial 127 Investigators. Maintenance treatment for patients with bipolar I disorder: results from a North American study of quetiapine in combination with lithium or divalproex (Trial 127). Am J Psychiatry. 2009;166:476-488.

    Google Scholar 

  125. Weisler RH, Nolen WA, Neijber A, et al; Trial 144 Study Investigators. Continuation of quetiapine versus switching to placebo or lithium for maintenance treatment of bipolar I disorder (Trial 144: a randomized controlled study). J Clin Psychiatry 2011; 72:1452-1464.

    Google Scholar 

  126. Macfadden W, Alphs L, Haskins JT, et al. A randomized, double-blind, placebo-controlled study of maintenance treatment with adjunctive risperidone long-acting therapy in patients with bipolar I disorder who relapse frequently. Bipolar Disord. 2009;11:827-839.

    Google Scholar 

  127. Vieta E, Nieto E, Autet A, et al. A long-term prospective study on the outcome of bipolar patients treated with long-acting injectable risperidone. World J Biol Psychiatry. 2008;23:1-6.

    Google Scholar 

  128. Vieta E, Goikolea JM. Atypical antipsychotics: newer options for mania and maintenance therapy. Bipolar Disord. 2005; 7(suppl 4):21-33.

    Google Scholar 

  129. Popovic D, Reinares M, Goikoles JM, et al. Polarity index of pharmacological agents used for maintenance treatment of bipolar disorder. Eur Neuropsychopharmacol. 2012;22:339-346.

    Google Scholar 

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  1. Hospital Clinic of Barcelona Bipolar Disorders Program, University of Barcelona, Barcelona, Spain

    Eduard Vieta

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Vieta, E. (2013). Pharmacological Management of Manic Episodes. In: Managing Bipolar Disorder in Clinical Practice. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-908517-94-4_8

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  • DOI: https://doi.org/10.1007/978-1-908517-94-4_8

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