Acute management of bipolar disorders

Acute bipolar presentations include manic, hypomanic, mixed, and depressive states. Manic presentations cannot be contained in a primary care setting and require psychiatric assessment for hospitalisation. Several drugs that have mood stabilising actions are now available, providing more treatment options for clinicians. Antidepressant use in bipolar depression remains controversial, but if considered clinically appropriate must be administered with a drug that stabilises mood. Psychosocial interventions help patients with recovery and to cope with residual symptoms of illness.