Acute Treatment of Mania, Mixed State, Rapid Cycling
- History and physical
- Labwork
- CBC with diff
- Lytes, creatinine
- LFT’s
- TSH
- EKG (if >40)
- U/A
- Pregnancy test if relevant
1st Line Treatments for Mania
- Monotherapy: Lithium, divalproex, Risperidone, Olanzapine, Quetiapine, Ziprasidone, Aripiprazole
- Combination: Lithium or divalproex plus Atypicals, except Ziprasidone (increases response by 20%)
- Rapid Cycling/Mixed: Divalproex
- Discontinue antidepressant, stimulant meds