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Although recommended by treatment guidelines for the treatment of depression in bipolar disorder, the evidence that lithium is superior to placebo for acute depression is low-quality; [21] [22] atypical antipsychotics are considered more effective for treating acute depressive episodes. [23]
The American Psychiatric Association's DSM-5 Tooltip Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the World Health Organization's ICD-10 Tooltip International Classification of Diseases (ICD-10), use the same criteria to diagnose bipolar disorder in adults and children with some adjustments to account for differences ...
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).
People with bipolar disorder often have other co-existing psychiatric conditions such as anxiety (present in about 71% of people with bipolar disorder), substance abuse (56%), personality disorders (36%) and attention deficit hyperactivity disorder (10–20%) which can add to the burden of illness and worsen the prognosis. [24]
In a double-blind, placebo-controlled, proof-of-concept study, researchers administered an N-methyl-d-aspartate–receptor antagonist to 18 patients already on treatment with lithium (10 patients) or valproate (8 patients) for bipolar depression.
On the other hand, lithium, an anti-manic medication, and anticonvulsant medications, often implicated in the treatment of bipolar disorder, show moderate reduction of aggression in hospitalized children with conduct disorder, and are often prescribed to children with DMDD based on this history. [25]