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A recent large-scale study found that severe depression in patients with bipolar disorder responds no better to a combination of antidepressant medications and mood stabilizers than it does to mood stabilizers alone and that antidepressant use does not hasten the emergence of manic symptoms in patients with bipolar disorder.
The drug seems ineffective in the treatment of current rapid-cycling, acute mania, or acute depression in bipolar disorder. [26] Lamotrigine has been shown to be as effective as lithium, the standard treatment for bipolar disorder. [27] Lamotrigine has not demonstrated clear efficacy in treating acute mood episodes, either mania or depression.
Lithium 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).
Olanzapine, sold under the brand name Zyprexa among others, is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder. [13] It is also sometimes used off-label for treatment of chemotherapy-induced nausea and vomiting [14] and as an appetite stimulant. [15]
Antipsychotic medications are effective for short-term treatment of bipolar manic episodes and appear to be superior to lithium and anticonvulsants for this purpose. [68] Atypical antipsychotics are also indicated for bipolar depression refractory to treatment with mood stabilizers. [ 120 ]
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