Medication		Indication			Comments
Medication		Acute mania	Maintenance	Bipolar depression	Comments
Antipsychotics, atypical					Antipsychotic medication plus lithium or an anticonvulsant is superior to monotherapy for acute mania Olanzapine and aripiprazole are effective in preventing manic relapse^7,27 Quetiapine plus lithium or valproate is superior to monotherapy for maintenance treatment
	Aripiprazole (Abilify)	Yes	No	No
	Olanzapine (Zyprexa)	Yes	Yes	Yes (plus SSRI)
	Quetiapine (Seroquel)	Yes	Yes	Yes
	Risperidone (Risperdal)	Yes	Yes	No
	Ziprasidone (Geodon)	Yes	No	No
Antipsychotics, typical		Yes	No	No	No difference in response rates among haloperidol, risperidone, olanzapine, carbamazepine, and valproate for acute mania
	Haloperidol lactate (Haldol)	Yes	No	No
Benzodiazepines		Yes	No	No	Used as combination therapy in patients with acute mania to reduce agitation⁶
	Lorazepam (Ativan)	Yes	No	No
Carbamazepine (Tegretol)		Yes	Yes	Yes	Evidence for carbamazepine is not as strong as that for lithium and valproate
Divalproex (Depakote), valproic acid (Depakene)		Yes	Yes	Yes	Valproate appears to be more effective than lithium for mixed states²⁸
Lamotrigine (Lamictal)		No	Yes	Yes	Acceptable agent in pregnancy; associated with weight loss in obese patients with bipolar I disorder²⁹
Lithium		Yes	Yes	Yes	Lithium lowers suicide risk compared with valproate or carbamazepine Lithium appears to be protective against dementia³⁰ Adding an SSRI or bupropion (Wellbutrin) does not improve depressive symptoms