Epidemiology:- Sex: ♀ = ♂Lifetime prevalence: 1-3%

Bipolar I disorder: One or more manic episodes (lasting ≥ 1 week) with or without major depressive episodesBipolar II disorder: One episode of hypomania + one episode of major depressive episode + no episodes of mania (distinguishing feature from bipolar I)Rapid cycling: ≥ 4 manic/hypomanic episodes or major depressive episodes per yearCyclothymic: Chronic and less severe, with alternating periods of hypomania and moderate depression for > 2 years

Clinical features:- Increased goal-directed activity (sexually, at work, and/or socially) or psychomotor agitation- Increased talkativeness or pressure of speech- Flight of ideas or racing thoughts- Loss of social inhibitions, socially inappropriate and reckless behavior, aggressiveness, and hostility- Decreased need for sleep- Overconfidence- Easily distracted

Diagnostics:- Manic episode: Lasts most of the day for at least 1 week- Hypomanic episode: Lasts most of the day for at least 4 consecutive days

Acute treatment:- General measures:→ Reduction of external stimuli→ Assessment for possible offending substances (e.g., cocaine, alcohol, PCP, etc.)→ Limit access to cars, bank accounts/credit cards, cell phones, etc., due to reckless behavior - Medication:→ Depressed: Quetiapine, lurasidone, olanzapine-fluoxetine→ Lithium, valproate, carbamazepine→ Antipsychotics: Olanzapine, aripiprazole, risperidone, ziprasidone, chlorpromazine→ Benzodiazepines

Long-term treatment- Duration of therapy:→ Treat for at least 1 year following an acute manic episode.→ Patients who experience 2 or more episodes should be considered for long-term or lifetime therapy.- Medication:→ First-line: Valproic acid, lithium→ Antipsychotics: Olanzapine, aripiprazole, risperidone, ziprasidone, chlorpromazine