[Psychopharmacological combination therapy in bipolar disorder]

In the course of time, the treatment regime of bipolar disorder has changed: in mild cases of manic and depressive episodes, monotherapeutic approaches are still commonly used. Besides the use of the common agents like lithium, valproatic acid and carbamazepine, other agents such as atypical antipsychotics (AAP) are used more frequently. For the therapy of manic episodes, most of the usual AAP are approved; some of them are or will be approved in the near future even for the continuation therapy and for depressive episodes. For moderate and severe courses of depressive or manic episodes, combination therapy strategies are used more often. Combination strategies seem to be more effective than monotherapeutic treatments, because of faster effects and better tolerance. In a lot of studies, these positive effects and advantages in contrast to monotherapeutic treatments could be proven. In this review article, studies and results with the focus on combination therapy will be summarised to recommend the "state-of-the-art"-treatment for bipolar disorder.