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. 2007 Dec;3(6):839–846. doi: 10.2147/ndt.s1264

Table 2.

Suggested first-line treatment strategies per available guidelines

Guidelines for the treatment of bipolar disorder
Non-psychotic mania Mixed mania Dysphoric mania Mania with a history of rapid cycling Euphoric mania Psychotic mania Bipolar depression
APA Severe: Li plus AP OR VPA plus AP Less Severe: monotherapy Li, VPA or AP Li OR VPA Li OR LAM
Expert Consensus 2004 Combination
MS plus AP
OR Monotherapy
MS		 Combo therapy and monotherapy received equivalent ratings Combination treatment and monotherapy received equivalent ratings Combination treatment and monotherapy received equivalent ratings MS MS plus AP
OR monotherapy
AP		 LAM monotherapy OR LAM plus Li for severe non- psychotic depression with a history of AD-induced mania or rapid cycling
TMAP Monotherapy VPA, ARP, RIS, ZIP Monotherapy Li, VPA, ARP, QTP, RIS, ZIP LAM plus anti-manic agent if recent and/or severe history of mania, all other patients LAM monotherapy

Abbreviation: AP, Antipsychotic; MS, Traditional Mood Stabilizer (carbamazepine, divalproex, lithium); Li, Lithium; VPA, Valproate; ARP, Aripiprazole; QTP, Quetiapine; RIS, Risperidone; ZIP, Ziprasidone; LAM, Lamotrigine; AD, Antidepressant.