First line mania Archives - Chris Aiken, MD

Cariprazine

First line schizophrenia, BP Depression, Bipolar, Treatments, Treatment Resistant Depression, First line mania, Mania, Mixed, Psychotic symptoms, Negative symptoms, Schizophrenia / Nancy Brandon

[$ Vraylar] Top for schizophrenia [1] because it improves negative symptoms. Bipolar depression [2] + mania [1], unipolar augmentation [2], but low effect size in depressions.

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Quetiapine

Generalized Anxiety, BP Depression, Bipolar, Treatments, First line mania, Anxiety, Treatment Resistant Depression, Deepen Sleep, OCD, Mania, Psychotic symptoms, Anxious Depression, Mixed, BP Anxiety, Schizophrenia / Nancy Brandon

[Seroquel] Unique antipsychotic – metabolized into an antidepressant so treats unipolar
depression (and GAD) as monotherapy. Top for TRD [1]. Deepens sleep. Tolerability poor, but among the most
effective options for BP-depression [1], BP-anxiety [2], mania, mixed.

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Lithium

Major Depression, First line BP depression, BP Depression, Bipolar, Treatments, Treatment Resistant Depression, First line mania, Psychotic Depression, Mania, Mixed, Negative symptoms, Schizophrenia / Nancy Brandon

Best long-term outcomes in bipolar (I or II) and recurrent depression. Prevents suicide. Treats mania, bp-depression and augments antidepressants.

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