Bipolar Disorder Practice Test

In acute mania, the goal is to rapidly calm the elevated mood, reduce risk behaviors, address any psychotic symptoms, and keep the person safe. A first-line approach combines a mood stabilizer with an antipsychotic. The mood stabilizer helps normalize the mood state and prevent cycling, with lithium, valproate, or carbamazepine chosen based on the clinical profile and any medical considerations. The antipsychotic provides faster relief of core manic symptoms such as grandiosity, pressured speech, and agitation, and can also treat any concurrent psychotic features. If the agitation or insomnia is prominent, a benzodiazepine may be added briefly to help sedation and sleep while the other meds take effect. Nonpharmacologic safety planning supports these medical steps by addressing immediate safety concerns, ensuring a stable environment, and coordinating care with support networks. Relying on antidepressants alone is not appropriate here because they can trigger or worsen a manic episode. Psychotherapy without medication typically cannot quickly control the acute, severe SAMPLEsymptoms of mania. Sedatives used alone do not stabilize mood or treat the underlying manic state. The combination of a mood stabilizer, an antipsychotic, and short-term benzodiazepine for agitation, plus safety planning, targets both the mood disturbance and safety needs of an acute manic episode.