Clinical Decision Making in the Treatment of Mania.

Nine agents are now Food and Drug Administration­approved for acute treatment of bipolar mania, and several other agents are being studied for efficacy. With multiple treatment options available, clinicians face the challenge of selecting among agents. Although clinicians may consult the American Psychiatric Association’s Practice Guideline for the Treatment of Patients With Bipolar Disorder, Second Edition, when selecting a treatment for bipolar mania, decisions about many aspects of treatment, such as choosing among agents, comparing combination therapy versus monotherapy, and individualizing treatments, remain complex. Considering data from recent clinical studies that have compared the efficacy, safety, and tolerability of medications for bipolar mania both between and within classes may facilitate such treatment decisions.