Treatment for Bipolar Disorder with Manic Behavior

First-Line Pharmacotherapy Options

• Other atypical antipsychotics, including aripiprazole, olanzapine, and ziprasidone, are approved for acute mania in adults, as recommended by the American Academy of Child and Adolescent Psychiatry 1, 2
• Lamotrigine is approved for maintenance therapy in adults with bipolar disorder but is not indicated for acute manic episodes, according to the American Academy of Child and Adolescent Psychiatry 2, 3

Treatment Algorithm for Acute Mania

• The American Academy of Child and Adolescent Psychiatry recommends beginning treatment with an FDA-approved agent for bipolar mania, such as atypical antipsychotics, for rapid symptom control 2

Important Caveats

• The American Academy of Child and Adolescent Psychiatry advises avoiding unnecessary polypharmacy while ensuring adequate symptom control, to minimize side effects 2
• SSRIs like citalopram should only be considered as adjunctive therapy for bipolar depression when the patient is already taking at least one mood stabilizer, as recommended by the American Academy of Child and Adolescent Psychiatry 4