Am Fam Physician. 2024;109(6):585-587
Author disclosure: No relevant financial relationships.
Key Points for Practice
• Quetiapine is effective for all phases of bipolar disorder—acute mania, acute depression, and maintenance therapy.
• Lithium is an effective medication for most phases of bipolar disorder treatment. Lithium may add protection against suicide but lacks evidence for treatment of acute bipolar depression.
• Psychotherapy, when added to pharmacotherapy, can be beneficial for people with bipolar disorder who are not acutely manic.
From the AFP Editors
Bipolar disorder has a lifetime prevalence of 1% in adults in the United States, and its onset peaks at three different ages—19, 26, and 29 years. The onset of bipolar disorder may be associated with asthma, migraines, multiple sclerosis, traumatic brain injury, and irritable bowel syndrome. More than 90% of patients with bipolar disorder report another mental health disorder, most commonly impulse control disorders, substance use disorders, and generalized anxiety disorder. The U.S. Department of Veterans Affairs and U.S. Department of Defense (VA/DoD) published new recommendations for diagnosing and managing bipolar disorder. These guidelines recommend management options when there is strong evidence of a benefit and suggest options when the evidence is not strong.
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