Bipolar Disorder

Bipolar disorder is a mood disorder with a lifetime prevalence rate between 1 and 2% that is defined by the occurrence of manic or hypomanic episodes although the course of illness is typically predominated by depression. The pathophysiology of bipolar disorder is complex and the burden of illness is high as bipolar disorder is a leading cause of years lost to disability. The pharmacological treatment of bipolar disorder involves the use of mood stabilizers including lithium, anticonvulsants, antipsychotics, antidepressants and other treatments which differ in their mechanisms of action, pharmacokinetics and side effect profiles. The evidence for the efficacy of these medications in the treatment of bipolar disorder tends to vary by illness phase: acute mania, acute depression or maintenance, the latter of which refers to the prevention of future mood episode recurrence. Even with proper diagnosis and treatment, the efficacy and effectiveness of available treatment options remains suboptimal. Few treatments have efficacy across all phases of bipolar illness and remission with a single agent remains an exception. Despite major advances in the treatment of bipolar disorder in recent decades, it is clear that many challenges remain in providing effective treatment.