TABLE 371-12 - Consensus Guidelines on the Drug Treatment of Acute Mania and Bipolar Depression

Condition	Preferred Agents
Euphoric mania	Lithium
Mixed/dysphoric mania	Valproic acid
Mania with psychosis	Valproic acid with olanzapine, conventional antipsychotic, or risperidone
Hypomania	Lithium, lamotrigine, or valproic acid alone
Severe depression with psychosis	Venlafaxine, bupropion, or paroxetine plus lithium plus olanzapine, orrisperidone; consider ECT
Severe depression without psychosis	Bupropion, paroxetine, sertraline, venlafaxine, or citalopram pluslithium
Mild to moderate depression	Lithium or lamotrigine alone; add bupropion if needed

Note: ECT, electroconvulsive therapy.
From GS Sachs et al: Postgrad Med April, 2000.