by Peter M. Brigham, MD

Note: I have not updated this site in quite a long time, and I am aware that it needs a substantial revision. Most pressing is the status of the atypical neuroleptics, which are now commonly accepted as effective antimanic agents and two of which have been approved for the treatment of bipolar depression. Please stay tuned for more up-to-date information. In the meantime, I encourage you to make use of the links labeled "search" that appear after each medication, which will take you to a MedLine search for recent articles on that medication in the treatment of bipolar disorder.

 (click to go to the relevant section)

Introduction

Diagnosis

 

DSM-4 diagnostic criteria
Differential diagnosis and comorbid factors

Treatment

 

 

Mood charting

 

Mood stabilizers

 

Accepted mood stabilizers

Lithium
Valproate
Olanzapine
Carbamazapine
Lamotrigine
ECT

 

Investigational mood stabilizers

Oxcarbazepine
Gabapentin
Topiramate
Tiagabine
Zonisamide
Levetiracetam
Adrenergic blockers
Ca-channel blockers
Acetazolamide
Anticholinesterase inhibitors
Mexilitine

 

Adjunctive treatments

 

Neuroleptics

Typical
Atypical

 

Other agents

Omega-3 fatty acids
Hormones
Tryptophan
5-HTP
Choline
Inositol
Thyroxine
Benzodiazepines
Melatonin
Stimulants
Atomoxetine

 

Special cases

Rapid cycling and mixed-state/dysphoric mania
Bipolar depression
Cyclothymia
Pregnancy & breastfeeding

 

 

 

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