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Bipolar I MaintenanceFirst Line: Monotherapy:  LithiumDivalproex or Divalproex ERQuetiapine or Quetiapine XRLamotrigine (effective at preventing depression)Olanzapine (effective at preventing mania)Aripiprazole (effective at preventing mania)Riperidone Consta / Long Acting Injection(effective at preventing mania)? Ziprasidone (in text, but not in table 5.5, effective at preventing mania)Combinations and Adjuncts:Adjunctive  Quetiapine,  Aripiprazole,  Risperdal  LAI,  and  ziprasidone  (adjunctive olanzapine and risperdal are second line)Second Line:Carbamazepine(similar  efficacy  to  lithium  maintenance  for  rates  of  relapes,  but more  dropouts  due  to  adverse  effects  with  carbamazpeine,  also  difficult  to combine with other psychotropics so second line)Paliperidone ERAdjunct: Lithium  and  Divalproex  (BALANCE study -combination  therapy  was  not significantly more effective than lithium alone, but more effective than divalproex monotherapy in preventing relapse)Adjunctive Olanzapine, RisperidoneThird Line (selected):AsenapineNot Recommended:GabapentinTopiramateAntidepressantsAdjunctive Flupenthixol

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it be like that sometimes 

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me irl

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Work of Richard Laeton.

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this is how my voice sounds in my head

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Digital art by Maxim Zhestkov 

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Every group project ever.

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YALL REALLY NEED TO STOP 😫😫

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