Practice Guideline for the Treatment of Patients With Bipolar Disorder (Revision)

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PART C:
Future Research Needs

VII. ACUTE TREATMENT

A. Manic and Mixed Episodes

1. What medication dosage and treatment duration can be considered an adequate trial?
2. In what circumstances is combination therapy favored over monotherapy?
3. Do different atypical antipsychotics exert different antimanic effects? Which combinations are most efficacious?
4. Can true antimanic properties of medications be distinguished from sedative properties of medications?

B. Depressive Episodes

1. How effective are newer antidepressants, such as SSRIs, in treating bipolar depression? How and when can they best be combined with other pharmacotherapies, such as lithium and valproate?
2. Do the different antidepressants have different relative efficacies?
   What medication dosage and treatment duration can be considered an adequate trial?
3. In treating an episode of bipolar depression, at what point in time is the addition of an antidepressant appropriate?

C. Rapid Cycling

1. Which pharmacotherapy regimens are most effective in the treatment of rapid cycling?
2. Do newer antidepressants or other medications truly differ in their propensity to induce rapid cycling or switches into hypomanic episodes?

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