Mania: diagnosis and treatment recommendations

Curr Psychiatry Rep. 2012 Dec;14(6):676-86. doi: 10.1007/s11920-012-0324-5.

Abstract

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 paper has distilled recommendations for both acute and long-term management. Antimanic agents including atypical antipsychotics and traditional mood stabilizers are employed to reduce acute manic symptoms, augmented by benzodiazepines if needed, and in refractory or severe cases with behavioural and/or psychotic disturbance, electroconvulsive therapy may occasionally be necessary. Maintenance/prophylaxis therapy aims to reduce recurrences/relapse, for which the combination of psychological interventions with pharmacotherapy is beneficial as it ensures adherence and monitoring of tolerability.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antimanic Agents / therapeutic use*
  • Antipsychotic Agents / therapeutic use*
  • Bipolar Disorder* / diagnosis
  • Bipolar Disorder* / drug therapy
  • Drug Therapy, Combination
  • Humans
  • Practice Guidelines as Topic

Substances

  • Antimanic Agents
  • Antipsychotic Agents