Core of treatment for bipolar disorder is a mood stabilizing agent (lithium, valproic acid, or carbamazepine)
Antipsychotic agents can be used as second line or augmenting agents in adults.
Lamotrigine may be used for the prevention of bipolar depression.
Antidepressant agents should be used with caution, and in general not without a mood stabilizing agent.
Combining medications with effective psychotherapy is the best treatment. Evidence based therapies for bipolar disorder include: Cognitive Behavioral Therapy, Interpersonal and Social Rhythm Therapy, Family Focused Therapy.
Suggested Additional Test/Management Prior to Specialty Visit
Prior to referral, baseline labs to help speed process of starting medications: Comprehensive metabolic panel, TSH, CBCPD, CHD, height, weight, waist circumference, medication levels (if applicable).
Provide a brief history of mental status at varying time points if able.
Encourage family members and/or a close friend to attend specialty evaluation appointment.