title: [Treatment standard for bipolar disorders].
abstract: Lithium has clearly been the standard drug for treatment of acute mania, bipolar depression and for prophylaxis of manic and depressive phase. However, recent reviews show acute failure rates of lithium to be over 50%. It is well recognized mixed state, dysphoric mania or rapid cycler appears less likely to respond to lithium. It has also been clarified that in these subtypes of mania valproic acid and carbamazepine may be more efficacious than lithium. As for the treatment of bipolar depression, consensus seems to be emerging that combined treatment with a mood stabilizer and SSRI or SNRI is the first choice because TCA with a mood stabilizer increases the risk of switch to mania.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Higuchi
mesh_terms: D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000628:therapy*; D002220:Carbamazepine / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D016651:Lithium Carbonate / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D002220:Carbamazepine; D016651:Lithium Carbonate; D017367:Selective Serotonin Reuptake Inhibitors; D014635:Valproic Acid