Substantial challenges face patients with bipolar disorder. In addition to their severe mood symptoms, there is frequent occurrence of psychiatric (anxiety disorders, alcohol or drug dependence) and general medical comorbidities (diabetes, cardiovascular disease, obesity, migraine, and hepatitis C virus infection). It has been reported that more than 75% of patients take their medication less than 75% of the time, and the rate of suicide (0.4%) among patients with bipolar disorder is more than 20 times greater than in the general US population. Mood stabilizers are the cornerstone of treatment of bipolar disorder, but atypical antipsychotics are broadly as effective; however, differences in efficacy exist between individual agents in the treatment of the various phases of bipolar disorder, including treatment of acute mania or acute depression symptoms, and in the prevention of relapse.
The report concluded that challenges involved in managing bipolar disorder over a patient’s lifetime are heavily dependent on the dynamic, chronic, and fluctuating nature of the disorder. Diligent selection of pharmacological treatment that takes into account its efficacy in the various phases of the disorder, along with its safety profile can help ameliorate the impact of this devastating condition.
Jann MW: Diagnosis and treatment of bipolar disorders in adults: a review of the evidence on pharmacologic treatments. Am. Health Drug Benefits 7(9): 489-499 (2014).

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