Mania: Diagnosis and Treatment Recommendations

  title={Mania: Diagnosis and Treatment Recommendations},
  author={Gin S. Malhi and Michelle Tanious and Michael Berk},
  journal={Current Psychiatry Reports},
This article provides recommendations for the diagnosis and treatment of mania, which characterizes bipolar I disorder (BD I). Failure to detect mania leads to misdiagnosis and suboptimal treatment. To diagnose mania, clinicians should include a detailed mood history within their assessment of patients presenting with depression, agitation, psychosis or insomnia. With regards to treatment, by synthesizing the findings from recent treatment guidelines, and reviewing relevant literature, this… Expand
Prolonged mania in a case of bipolar affective disorder.
  • Ather Muneer
  • Medicine
  • JPMA. The Journal of the Pakistan Medical Association
  • 2014
In a case where manic symptoms are showing resistance, an evidence-based pharmacotherapuetic approach by the treating physician is essential and the provision of psychological and social support to the patient is vital in conjunction with biological measures for optimal management. Expand
The Diagnosis and Management of Bipolar I and II Disorders: Clinical Practice Update
  • W. Bobo
  • Psychology, Medicine
  • Mayo Clinic proceedings
  • 2017
Mood symptoms, psychosocial functioning, and suicide risk must, therefore, be continually reevaluated, and, when necessary, the plan of care must be adjusted during long‐term treatment. Expand
Treatment of Bipolar Disorder in a Lifetime Perspective: Is Lithium Still the Best Choice?
The available evidence indicates that bipolar disorder patients should be treated primarily with lithium, combined in some cases with antipsychotics especially in acute treatments, and sometimes, because of intolerance or inefficacy of lithium, with anticonvulsants. Expand
Towards the clinical implementation of pharmacogenetics in bipolar disorder
It is argued that based on the sufficiency of accumulated evidence, PGT implementation studies are now warranted and the design for a randomized clinical trial to test the use of PGT in the treatment of BD is proposed. Expand
The use of benzodiazepines in bipolar disorders
Although benzodiazepines have many benefits for patients with bipolar disorders, their use must be very cautious, because of the associated risk of misuse and other possible consequences, especially in some particular clinical situations. Expand
Enhancing stability in bipolar disorder
Results Mood stabilizers are the first-line treatment during manic, hypomanic and mixed episodes of BD. Lithium still represents the gold standard among all the currently available treatments of BD.Expand
Bipolar disorder
Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance, and detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Expand
Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial.
Adjunctive benzodiazepines may not significantly affect clinical outcome in lithium- or quetiapine-treated patients with bipolar I or II disorder over 6 months, after controlling for potential confounding factors. Expand
Evidences of possible side effects of neuroleptic drugs: A systematic review
The focus of research in this area should be the concern or repudiation of a causal relationship between chronic neuroleptic use and psychotic relapse, even though at hand article would eradicate to researchers to find out a compiled revision on probable side effects of neuroleptics. Expand
Efficacy and Safety of Asenapine Versus Olanzapine in Combination With Divalproex for Acute Mania: A Randomized Controlled Trial.
It is found that asenapine was an effective and well-tolerated atypical antipsychotic alternative to olanzapine in combination with divalproex for the short-term management of acute mania. Expand


New treatment guidelines for acute bipolar mania: a critical review.
Recent guidelines focusing on the treatment of manic/hypomanic and mixed episodes, including benefit-risk ratio issues, starting with combination versus monotherapy, and how to deal with treatments which are more experience-based than evidence-based are reviewed. Expand
Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry
A systematic review of the available data concerning the efficacy of medication treatment of bipolar disorder (BP) suggests that lithium, first and second generation antipsychotics and valproate and carbamazepine are efficacious in the treatment of acute mania. Expand
Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies.
The guidelines suggest that although pharmacotherapy forms the cornerstone of management, utilization of adjunctive psychosocial treatments and incorporation of chronic disease management model involving a healthcare team are required in providing optimal management for patients with bipolar disorder. Expand
Prevalence of mixed mania using 3 definitions.
The definition of mixed episodes for BD must be revised to improve consensus and, consequently, therapeutic management as current diagnostic systems only capture a limited proportion of patients suffering from mixed episodes. Expand
Asenapine: a review of its use in the management of mania in adults with bipolar I disorder.
Asenapine monotherapy is a further option for the management of manic and/or mixed symptoms in patients with bipolar I disorder and may be of particular value for patients who are at high risk for metabolic abnormalities. Expand
Medicating mood with maintenance in mind: bipolar depression pharmacotherapy.
The evidence from treatment trials favours the use of lithium and lamotrigine as first-line treatment in preference to valproate, and indicates that, for acute episodes, quetiapine and olanzapine have perhaps achieved equivalence at least in terms of efficacy. Expand
Efficacy of psychoeducational approaches on bipolar disorders: a review of the literature.
It is suggested that psychoeducation should be part of the integrated treatment of bipolar disorder, notably by increasing the patients' and their families' knowledge of the disorder and of treatment options, by decreasing the risk of (hypo)manic or depressive relapse and of hospitalization and by improving treatment compliance. Expand
Evidence-based guidelines for treating bipolar disorder: revised second edition--recommendations from the British Association for Psychopharmacology.
  • G. Goodwin
  • Medicine
  • Journal of psychopharmacology
  • 2009
The British Association for Psychopharmacology guidelines specify the scope and target of treatment for bipolar disorder, and are presented as recommendations to aid clinical decision making for practitioners: they may also serve as a source of information for patients and carers. Expand
Bipolar pathophysiology and development of improved treatments
  • C. Bowden
  • Medicine, Psychology
  • Brain Research
  • 2008
Evidence indicates that additional consideration of principal behavioral domains of bipolar symptomatology, e.g., anxiety, psychosis, impulsivity, elevated psychomotor and cognitive processing speed, rather than strictly depressive or manic syndromes can provide more homogeneous samples for study, and increase the focus of experimental hypotheses. Expand
Lithium specificity in bipolar illness: a classic agent for the classic disorder.
It is demonstrated that lithium possesses significant clinical and therapeutic efficacy that is very individual and thus remains the treatment of choice for bipolar disorder when used specifically in select patients and its phenotypic specificity of action. Expand