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Home Formulary 4.0 Central Nervous System 4.2 Drugs used in psychoses and related disorders 4.2.3 Mood stabilising drugs 4.2.3.1 Treatment of the acute phase of mania

4.2.3.1 Treatment of the acute phase of mania

Prescribing Notes

  • Refer all people in a hypomanic or manic episode for specialist mental health assessment. Contact a mental health specialist for advice on initial management while the person is waiting to be seen in secondary care. An antipsychotic may sometimes be recommended in the interim
  • Primary treatment for hypomania or mania is usually with an antipsychotic agent. See NICE CG 185 Bipolar disorder
  • If the person is already taking lithium, check plasma lithium levels to ensure they are within therapeutic range and to check concordance
  • Consider stopping antidepressant (on specialist advice)
  • Modified release preparations of quetiapine should be reserved for patients with compliance issues

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