Treatment of bipolar disorder: a systematic review of available data

Analysis of results: The literature suggests that lithium is useful during all phases of bipolar illness and it has a specific effectiveness on suicide prevention. Both first and second generation antipsychotics are efficacious in the treatment of acute mania. Quetiapine and olanzapine are also effective for treating bipolar depression. Anticonvulsants, particularly valproate and carbamazepine have antimanic properties, whereas lamotrigine may be preferably effective in the treatment of depression but not mania. Antidepressants should always be used in combination with an antimanic agent, because they may induce switching to mania or hypomania, mixed episodes and rapid cycling. The first line of psychosocial intervention in BD is psychoeducation, family-focused psychoeducation, and cognitive-behavioral therapy. Electroconvulsive therapy and transcranial magnetic stimulation are options for refractory patients. Conclusions Although a variety of treatment options for bipolar disorder are available today, their effectiveness is far from satisfactory, especially against bipolar depression. Combination techniques might improve the outcome; however there is still lack of data in this field. Research in this field is necessary as well as the development of better guidelines for step-by-step combination treatment. from International Society on Brain and Behaviour: 3rd International Congress on Brain and Behaviour Thessaloniki, Greece. 28 November – 2 December 2007