title: Current and emerging therapies for the management of bipolar disorders.
abstract: Bipolar disorder is a complex condition to treat because agents that may be effective for a specific phase may not be effective for other phases, or may even worsen the overall course of the illness. Over the last decade there has been an increase in research activity in the treatment of bipolar illness. There are now several agents that are well established for the treatment of acute mania (lithium, divalproex, carbamazepine, nearly all antipsychotics), acute bipolar depression (lamotrigine, quetiapine, olanzapine/fluoxetine combination), and relapse prevention (lithium, lamotrigine, divalproex, most second generation antipsychotics). There are also novel treatments that are being studied for all three phases. These include eslicarbazepine, cariprazine, MEM-1003, memantine, tamoxifen and pentazocine for acute mania; pramipexole, modafinil, armodafinil, divalproex, lurasidone, agomelatine, cariprazine, lisedexamfetamine, riluzole, RG-2417, bifeprunox, ropinirole, GSK1014802, and magnetic stimulation for bipolar depression; and asenapine, lurasidone, and cariprazine for relapse prevention. Additionally, there are accumulating data that antidepressants, particularly serotoninergic ones, are not particularly effective in acute bipolar depression and may worsen the course of the illness.
authors.affiliation: Mood Disorders Research Program, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA.
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
authors.forename: Ahmed Z
authors.initials: AZ
authors.lastname: Elmaadawi
authors.forename: Yonglin
authors.initials: Y
authors.lastname: Gao
authors.forename: Kavita
authors.initials: K
authors.lastname: Lohano
authors.forename: R Jeannie
authors.initials: RJ
authors.lastname: Roberts
keywords: Bipolar disorder; armodafinil; cariprazine; lithium; modafinil; pramipexole; treatment