Table 5.

Initial treatment strategies for geriatric bipolar disorder

	First-line treatment	High second-line treatment	Low second-line treatment
Manic episode	AAP/MS monotherapy MS plus AAP		MS plus LTG/TAP/other AAP MS plus LTG plus AAP/other AAP/TAP ECT TAP monotherapy
Depressive episode	AAP monotherapy AAP plus MS/LTG	MS/LTG monotherapy MS plus LTG/AD	TAP/AD monotherapy AD plus AAP/LTG TAP plus MS/AD MS plus AD plus TAP MS plus AAP plus LTG/AD MS plus AAP plus LTG plus AD ECT

Note: Bold: no consensus.

Abbreviations: AAP, atypical antipsychotics; AD, antidepressant; ECT, electroconvulsive therapy; LTG, lamotrigine; MS, mood stabilizer; TAP, typical antipsychotics.