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Bipolar Disorder Medications

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According to The American Psychiatric Association's "Guideline For The Treatment Of Patients With Bipolar Disorder" acute episodes of mania are usually treated with a mood stabilizer (lithium or valproate) plus an antipsychotic. Once the patient has been stabilized, the psychiatrist may reassess the continuing need for an antipsychotic medication in addition to the mood stabilizer. For acute depressive episodes, APA guidelines recommend a mood stabilizer. Use of anti-depressants must be used judiciously because of their tendency to trigger a manic episode (although this is less likely in patients diagnosed with Bipolar II). If used, an anti-depressant should always be taken in conjunction with a mood stabilizer.

In both the acute and the maintenance phase of treatment, psychotherapy (always in addition to pharmacological treatment) may be helpful to address illness management, social/vocational rehabilitation, and adherance to a treatment plan. Another treatment sometimes used for medication-resistant bipolar disorder is electroconvulsive therapy (ECT), for depression.

          Compound Trade Name Method of Action and Proposed Effect FDA Trials Phase
          RU 486 Mifepristone glucocorticoid antagonist; antidepressant Phase II
          Riluzole Rilutek glutamate antagonist; antidepressant Phase II
          Pramiprexole Miraprex dopamine agonist; antidepressant Phase II
          Tamoxifen   PKC inhibitor; mood stabilizer Phase II
          Felbamate Felbatol glutamate antagonist; antidepressant Phase II




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