Mania acute attack

Antipsychotic drugs, such as flupentixol and haloperidol are the mainstay of treatment for acute attacks of mania. Lithium is not indicated as it may take a few days before the drug exerts an effect. Lithium may be given concomitantly with an antipsychotic drug. 

Rapid control of an acute attack of mania may require the use of a neuroleptic (see below). 

Q5 Lithium (lithium carbonate or citrate) is administered in doses of between 0.2 and 1.5 g daily. The dose is monitored to provide a therapeutic plasma level of 0. 4-1.0 mmol l-1 12 hours after the most recent dose taken on days 4-7 of treatment. The plasma concentration is then measured every week until the dosage has been stabilized and the required concentration has remained constant for four weeks. Lithium can take several days to become effective. If a patient is suffering an acute attack of mania and is excessively disturbed, treatment with an antipsychotic drug may also be required. The antipsychotic... 

---