Drug of choice in bipolar disorder is?

Ans. is 'b' i.e., Lithium carbonate Treatment of Bipolar disorder1) Treatment of acute episodes : - It depends on the type of episode, i.e., manic (acute mania) or depression : -a) Treatment of Acute Mania: - The treatment of acute mania or hypomania is the easiest phases of bipolar disorders to treat. Drugs used for the treatment of acute mania are: -i) Lithiumii) Valproateiii) Carbamazepine, Oxcarbazepineiv) Atypical & typical antipsychotics : - Olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, Haloperidol, Chlorpromazine.v) Benzodiazepines: - Clonazepam or Lorazepam can be used as adjunctive treatment for agitation, aggression, insomnia.ConditionPreferred agent* Hypomania* Lithium or Valproic* Mania* Lithium* Mania with dysphoria (mixed mania)* Valproic acid* Mania with psychosis* Valproate with olanzapine or risperidoneb) Treatment of acute bipolar depression: - Antidepressants with a mood stabilizer is used as using antidepressant alone in depressive episode of bipolar disorder can precipitate manic or hypomanic episode. If patient does not respond to standard antidepressants lamotrigine or ziprasidone can be used.Mild or moderate depressionLithium or lamotrigine alone, Add antidepressant (Bupripion) if needed.Severe depressionAntidepressant (Bupripione, Fluoxetine, sertaline) plus lithiumSevere depression with psychosisAntidepressant plus lithium plus olanzapine or risperidone.2) Maintenance treatment: - It is used to prevent the recurrence after acute episode has been controlled, i.e., Prophylactic treatment for bipolar disorder. Three drugs are commonly used: -i) Lithium (drug of choice)ii) Carbamazepine.iii) Valproate,iv) Other drugs which can be used are topiramate, Lamotrigine, atypical antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone, Clozapine) and Gabapentin.3) Treatment of rapid cycling: -i) Valproate is the drug of choiceii) Other drugs used are Carbamazepine, Lithium, Lamotrigine.