Fig. (1).

Maintenance of the different types of BDs recommends the use of mood stabilizers (Lithium or VPA) as first-line treatment. When mood stabilizers are not enough, AAPs can be used as an adjunctive strategy, carefully monitoring the increased risk of serious adverse effects. *Quetiapine (Que) and, less consistently, Aripiprazole (Ari) are recommended as second-line treatment for their safety and tolerability compared to the other AAPs. **The association of Lithium and VPA is a second-line strategy in BD with AUD and anxiety. ***Stronger AAPs, like Risperidone and Olanzapine, are mostly recommended for BD with severe psychotic features as a third-line treatment for their risk of serious adverse reactions, especially in the long-term. ****Clozapine (Cloz) is recommended as a third-line treatment for drug-resistant BD, although its rare life-threatening side effects (e.g., agranulocytosis) impose a constant monitoring of patients’ conditions.