Long-Term Treatment of Bipolar Disorder in Adults

Bipolar disorder is a common, chronic, multidimensional syndrome that appears to be a progressive illness, in that each episode substantially increases the risk that another episode will occur and will be less responsive to treatment than previous episodes. The biphasic and episodic nature of bipolar disorder substantially contributes to its negative impact on patients’ quality of life as well as their physical, social, and occupational functioning. Patients with bipolar disorder often have co-occurring conditions, particularly medical comorbidities, and, unfortunately, several psychotropic medications prescribed to treat bipolar disorder may increase the risk of developing certain medical illnesses. Although the recommendation in psychiatric care is to regularly assess patients’ physical health, many clinicians are not yet implementing this strategy in their clinical practice. When making evidence-based medication choices, clinicians can select from several FDA-approved agents for the treatment of acute manic and depressive episodes as well as for maintenance therapy. Additionally, psychotherapies are effective when used in combination with pharmacotherapy.