Abstract
The knowledge base regarding the medical treatment of acute bipolar mania is rapidly
expanding. Information about agents with established antimanic properties is increasing,
and more agents with putative antimanic properties are being identified. We first
review the controlled studies supporting the efficacy of the established antimanic
agents lithium, valproate, and carbamazepine and standard antipsychotics. We then
review available research on two important classes of drugs that are emerging as potential
treatments for acute mania: the novel antipsychotics, which include clozapine, olanzapine,
quetiapine, risperidone, and ziprasidone, and the new antiepileptics, which include
gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, and zonisamide. We
conclude that although controlled data are accumulating to support the efficacy of
several atypical antipsychotics in the treatment of acute bipolar mania, particularly
olanzapine, ziprasidone, and risperidone, the novel antiepileptics need more extensive
study before it can be concluded that any of them possess specific antimanic properties.
We also conclude that as the medical options for acute bipolar mania expand, treatment
guidelines must remain both evidence based and flexible, so that they represent cutting
edge medical science yet can be tailored to the specific needs of individual patients.
Keywords
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Article info
Publication history
Accepted:
June 7,
2000
Received in revised form:
June 7,
2000
Received:
February 4,
2000
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
