Advances in the treatment of mania

Lithium is, to this date, still the first choice in the treatment of acute mania, while valproate and carbamazepine are generally very useful second options. Ideally, it is best if the drug used in the acute treatment phase can also be maintained during the prophylactic phase of treatment, possibly as monotherapy. In poor responders, antipsychotics, benzodiazepines, or both may be added to the first-line mood stabilizer for short periods of time. Newer anticonvulsants and calcium channel blockers may also be considered for treatment-resistant subjects, but their efficacy needs to be further evaluated in controlled studies.