Step II Psychiatry Question

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colonelmustard

What is the first line treatment for episodes of mania and bipolar disorder type 1? I thought it's a mood stabilizer like lithium. However, UWorld says the first line is an atypical antipsychotic with the addition of lithium in severe cases. Are atypical antipsychotics used as monotherapy for mania?

I'd appreciate it if someone can clear this up.
 
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colonelmustard said:
What is the first line treatment for episodes of mania and bipolar disorder type 1? I thought it's a mood stabilizer like lithium. However, UWorld says the first line is an atypical antipsychotic with the addition of lithium in severe cases. Are atypical antipsychotics used as monotherapy for mania?

I'd appreciate it if someone can clear this up.
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Mood stabilizers like lithium are used to treat chronic bipolar. If I remember the Uworld question you are talking about, that person was having an acute manic episode and therefore needs more rapid stabilization which would be an atypical antipsychotic. I may be wrong though. Been awhile since I took CK.
 
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I was wondering the same thing. I also just read that for hypomania or mild to moderate mania, atypical antipsychotic monotherapy was preferred above lithium monotherapy but lithium is a reasonable option.
It said that for severe episodes, it was recommended to start Lithium plus an antipsychotic.

It caught me by surprise because I thought that lithium was preferred for monotherapy with antipsychotics thrown in if needed but it seems to be the other way around.
 
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