Bipolar disorder (maintenance)
- Continue effective acute drug when suitable
- Lithium has strong anti-suicide evidence
- Lamotrigine better for depressive prevention
- Valproate often better for manic polarity
- Several SGAs also prevent recurrence
- Match maintenance to prior episode pattern
- Avoid abrupt discontinuation
Use at a glance
- Continue effective acute drug when suitable
Practical pearls
- Match maintenance to prior episode pattern
Other practical pearls
- Lithium has strong anti-suicide evidence
- Lamotrigine better for depressive prevention
- Valproate often better for manic polarity
- Several SGAs also prevent recurrence
Safety / pitfalls
- Avoid abrupt discontinuation
Self-check
- What guides bipolar maintenance selection?
Prior episode pattern. - Which stopping pattern is avoided in bipolar maintenance?
Abrupt discontinuation.
Drugs used for this (4)
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