Treatment approaches to mania

Treatment of manic episodes is an urgency because of the lack of insight and excessive psychomotor activity. Over the past two decades various new modes of pharmacological treatment of this condition has been reported. Along with them, biochemical findings in manic patients have been exhaustively investigated. Etiologically based pharmacological treatment of manic episodes will help us therapeutically in improving the condition of the patient and scientifically, to confirm or explore biochemical basis of manic episodes. The new innovative approaches for the treatment of manic episodes need to be applied in treating therapy-resistant patients. Included in this paper are treatment approaches based on norepinephrine, dopamine, acetylcholine, serotonin, gamma-aminobutyric acid and permissive hypothesis, peripheral autonomic imbalance, endocrine abnormalities, electrolyte disturbances, paradoxical response, and cyclic AMP. In addition, use of antidepressants and pyrotherapy is described.