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In light of recent evidence, olanzapine (Zyprexa) has been FDA approved as an effective monotherapy for the maintenance of bipolar disorder. [22] A head-to-head randomized control trial in 2005 has also shown olanzapine monotherapy to be just as effective and safe as lithium in prophylaxis. [23]
Lamotrigine is approved in the US for maintenance treatment of bipolar I disorder and bipolar II disorder. [25] While the anticonvulsants carbamazepine and valproate are predominantly antimanics , lamotrigine has demonstrated efficacy only in preventing or reducing the risk of recurrent depressive episodes of bipolar disorder.
Lithium is the "classic" mood stabilizer, the first to be approved by the US FDA, and still popular in treatment. Therapeutic drug monitoring is required to ensure lithium levels remain in the therapeutic range: 0.6 to 0.8 or 0.8–1.2 mEq/L (or millimolar). Signs and symptoms of toxicity include nausea, vomiting, diarrhea, and ataxia. [3]
In 2013, it was approved in Canada and by the U.S. Food and Drug Administration (FDA) to treat bipolar depression, either as monotherapy or adjunctively with lithium or valproate. [15] [16] It has no effect on manic symptoms and is more potent for treating major depressive disorder or depressive episodes associated with bipolar disorder ...
Lithium is the only medication approved by the FDA for treating mania in children. In the 1920s, Kraepelin noted that manic episodes are rare before puberty. [124] In general, bipolar disorder in children was not recognized in the first half of the twentieth century.
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