Bipolar disorder pharmacotherapy

Abstract

Treatment options in the management of bipolar disorder continue to proliferate. Currently, all of the commonly prescribed atypical antipsychotics are indicated for the treatment of mania. Quetiapine and olanzapine/fluoxetine in combination are US FDA approved in the treatment of bipolar depression. Aripiprazole and lamotrigine have been FDA approved as maintenance therapies in the long-term management of bipolar disorder. Topiramate and gabapentin have been effectively discredited as first-line options in acute mania. This update seeks to summarize recent developments in bipolar disorder pharmacotherapy, offer insight into the nuance of using these newer agents effectively, review risks and benefits of using standard antidepressants in the treatment of bipolar depression and draw to the attention of readers the strengths and limitations of some of the studies that are shaping contemporary psychiatry’s approach to the patient with bipolar disorder.