Antipsychotic mood stabilizers are our "go to" drugs for acute mania or mixed states in people with bipolar disorder, particularly severe forms of these states that threaten safety or place the patient in the hospital or at risk of hospitalization. Their advantages include that they can be rapidly introduced, rapidly adjusted, and often can, at the cost of some annoying side effects, bring the acute mania or agitation of a mixed state under control in 24 to 72 hours. This rapid effect is not shared by the other mood stabilizers. Prior to the advent of antipsychotic mood stabilizers, an acutely manic patient was typically hospitalized for many weeks as the more traditional mood stabilizers slowly took hold.
Another advantage is found in patients who experience hallucinations, paranoia, delusions (false beliefs that things are happening that in fact, are not happening), or other symptoms of the inability to distinguish that which is real from that which is not (the definition of psychosis). The antipsychotic mood stabilizers are the best agents for addressing these psychotic symptoms.
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