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Updated: Jan 27, 2026

Developing a Rat Model for Bipolar Disorder
Published on: May 2, 2025
Controversies in bipolar disorder; role of second-generation antipsychotic for maintenance therapy
Sameer Jauhar1,2, Allan H Young3
1Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, SE5 8AF, UK. sameer.jauhar@kcl.ac.uk.
Abstract:
In this narrative review, we discuss use of second-generation antipsychotics (SGAs) in maintenance treatment of bipolar disorder. We compare their use to historically more established treatments (particularly lithium, the gold standard). To compare we review evidence on efficacy, effectiveness and tolerability across illness poles, possible mechanisms of treatment response, guidance given by guideline groups and pragmatic clinical considerations. We then illustrate the controversies in maintenance antipsychotic use, with the example of first episode mania and its treatment within first episode psychosis services. Finally, we make suggestions for future studies to unpick these differences.
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