What is considered the gold standard for treating bipolar disorder?

Lithium is recognized as the gold standard for treating bipolar disorder due to its well-established efficacy in both the acute management of manic and depressive episodes and in the long-term maintenance treatment to prevent recurrence. Research has consistently demonstrated that lithium not only stabilizes mood but also reduces the risk of suicide in individuals with bipolar disorder. Its effectiveness in maintaining mood stability is attributed to its unique mechanism of action, which influences neurotransmission and provides neuroprotective effects.

While other options such as valproic acid, lamotrigine, and carbamazepine are also used in the treatment of bipolar disorder, they are generally considered adjunctive therapies or alternatives when lithium is not suitable or adequately effective. Valproic acid is commonly used for rapid cycling and mixed episodes, while lamotrigine is particularly effective in the depressive phase. Carbamazepine is utilized in certain cases as well, especially in acute manic episodes. However, none of these alternatives have the same extensive body of evidence supporting their use as a first-line treatment in contrast to lithium's demonstrated long-term benefits, making lithium the definitive choice in clinical guidelines and practice for managing bipolar disorder.