The first treatment for bipolar disorder often happens in the "acute" phase, when a person may have his or her first manic episode. In the acute phase, you may be suicidal, psychotic, or using such poor judgment that you are in danger of harming yourself. Your doctor may decide you should be hospitalized for your own safety, especially if he or she believes you are suicidal. Medications that may be used for initial treatment include:

• Mood stabilizers, such as lithium carbonate (Eskalith, Lithane, and Lithobid). Experts believe lithium may affect certain brain chemicals (neurotransmitters) that cause mood changes, but how the medication works is not completely understood. Anticonvulsants, such as valproate sodium (Depakene Syrup), divalproex (Depakote), and carbamazepine (Tegretol) are also mood stabilizers. Valproate and divalproex are used to treat manic episodes. The anticonvulsant lamotrigine was recently approved for the long-term maintenance treatment of bipolar I disorder and may be helpful for depression. Anticonvulsants can be helpful in hard-to-treat bipolar episodes. A mood stabilizer and an antipsychotic are often used as the first medications for acute manic episodes.
• Atypical antipsychotics, such as olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). Antipsychotics quickly improve manic episodes. Olanzapine may be used in combination with mood stabilizers and anticonvulsants.
• Benzodiazepines, such as diazepam (Valium), which may be used instead of antipsychotics or as an additional medication during a manic