Bipolar disorder: an update.

Abstract	There has been a recent increase in the number of clinical trials and treatment options for bipolar disorder. This research has resulted in new treatment options. Most second-generation antipsychotics have demonstrated efficacy in the treatment of mania, both in monotherapy and as adjuncts to mood stabilizers. For bipolar depression, nearly all randomized, placebo-controlled studies have demonstrated that antidepressants do not provide any additional benefit to ongoing mood stabilizers. Additionally, antidepressants carry a risk of destabilization of bipolar disorder with an increase in mania, cycling, and chronic irritable dysphoria. Newer non-antidepressant treatments for depression include quetiapine, lamotrigine, modafinil, and pramipexole. These agents are effective for acute treatment and appear to be effective in maintenance. The least-studied phase of bipolar disorder is the maintenance phase. The use of multiple agents appears to be superior to monotherapy in relapse prevention. Despite the many advances in the pharmacotherapy of bipolar disorder, the overall prognosis of this severe illness does not appear to have changed.
Authors	Rif S El-Mallakh, Ahmed Z Elmaadawi, Muruga Loganathan, Kavita Lohano, Yonglin Gao
Journal	Postgraduate medicine (Postgrad Med) Vol. 122 Issue 4 Pg. 24-31 (Jul 2010) ISSN: 1941-9260 [Electronic] England
PMID	20675968 (Publication Type: Journal Article, Review)
Chemical References	Anticonvulsants Antidepressive Agents Antipsychotic Agents Benzhydryl Compounds Benzothiazoles Dibenzothiazepines Dopamine Agonists Triazines Quetiapine Fumarate Pramipexole Modafinil Lamotrigine
Topics	Anticonvulsants (adverse effects, therapeutic use) Antidepressive Agents (adverse effects, therapeutic use) Antipsychotic Agents (adverse effects, therapeutic use) Benzhydryl Compounds (adverse effects, therapeutic use) Benzothiazoles (adverse effects, therapeutic use) Bipolar Disorder (diagnosis, drug therapy) Diagnosis, Differential Dibenzothiazepines (adverse effects, therapeutic use) Dopamine Agonists (adverse effects, therapeutic use) Humans Lamotrigine Modafinil Pramipexole Prognosis Psychotherapy Quetiapine Fumarate Randomized Controlled Trials as Topic Triazines (adverse effects, therapeutic use)

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