title: Mania: diagnosis and treatment recommendations.
abstract: This article provides recommendations for the diagnosis and treatment of mania, which characterizes bipolar I disorder (BD I). Failure to detect mania leads to misdiagnosis and suboptimal treatment. To diagnose mania, clinicians should include a detailed mood history within their assessment of patients presenting with depression, agitation, psychosis or insomnia. With regards to treatment, by synthesizing the findings from recent treatment guidelines, and reviewing relevant literature, this paper has distilled recommendations for both acute and long-term management. Antimanic agents including atypical antipsychotics and traditional mood stabilizers are employed to reduce acute manic symptoms, augmented by benzodiazepines if needed, and in refractory or severe cases with behavioural and/or psychotic disturbance, electroconvulsive therapy may occasionally be necessary. Maintenance/prophylaxis therapy aims to reduce recurrences/relapse, for which the combination of psychological interventions with pharmacotherapy is beneficial as it ensures adherence and monitoring of tolerability.
authors.affiliation: CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Level 5, Building 36, St Leonards, Sydney, NSW, 2065, Australia. gin.malhi@sydney.edu.au
authors.forename: Gin S
authors.initials: GS
authors.lastname: Malhi
authors.forename: Michelle
authors.initials: M
authors.lastname: Tanious
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents