Estrategias para el cambio de antipsicótico en el tratamiento del trastorno bipolar

With the increasingly widespread use of antipsychotics in bipolar disorder, the switch between antipsychotics and between antipsychotics and mood stabilizers has become more usual, especially since the introduction of the atypical antipsychotics, some of which have mood stabilizer properties. The evidence-based medicine for antipsychotic switch in psychotic disorders has been broadly described, however, in bipolar disorder, is far more meager. Despite the extensive work in the field of antipsychotics in bipolar disorder and the expected prompt results of the ongoing clinical trials, a formally evaluated and clearly articulated approach of antipsychotic switch in bipolar disorder is still lacking. Nevertheless, some sensible rules are recommended to be followed in the management of antipsychotics in bipolar disorder: first of all, take time to choose the appropriate treatment for each particular patient; thereafter reach the maximum optimal dose and in the case that the patient shows intolerance to treatment or low response to treatment, proceed to the antipsychotic switching.