Table 5.
Levels of recommendation concerning adjunctive treatment for resistant acute mania and recommended dosages for medication options
| Treatment modality to add | Grading | ||
|---|---|---|---|
| In terms of efficacy | In terms of recommendation | Dosage | |
| Aripiprazole | 2 | 1 | Up to 30 mg/d |
| Asenapine | 2 | 1 | Up to 20 mg/d |
| Quetiapine | 1 | 1 | Up to 800 mg/d |
| Valnoctamide | 2 | 1 | 1200 mg/d |
| Haloperidol | 2 | 2 | Up to 12 mg/d |
| Olanzapine | 2 | 2 | Up to 40 mg/d |
| Phenytoin | 3 | 3 | 400 mg/d |
| Allopurinol | 4 | 4 | 600 mg/d |
| Carbamazepine | 4 | 4 | Up to 1200 mg/d |
| Clozapine | 4 | 4 | Up to 550 mg/d |
| ECT | 4 | 4 | – |
| Folic acid | 4 | 4 | 3 mg/d |
| Leviracetam | 4 | 4 | 2000–3000 mg/d |
| l-Thyroxine | 4 | 4 | Until FT4 higher than upper limit |
| Oxcarbazepine | 4 | 4 | Up to 1200 mg/d |
| Pregabaline | 4 | 4 | 75–150 mg/d |
| Donepezil | NR | NR | |
| Gabapentin | NR | NR | |
| Lamotrigine | NR | NR | |
| Lovastatin | NR | NR | |
| Nifedipine | NR | NR | |
| Paliperidone | NR | NR | |
| Ramelteon | NR | NR | |
| Risperidone | NR | NR | |
| Topiramate | NR | NR | |
| Verapamil | NR | NR | |
| Ziprasidone | NR | NR |
Abbreviations: ECT, electroconvulsive therapy; FT4, free-T4; NR, not recommended.