Long-term maintenance therapy with a mood stabilizer is recommended in bipolar I disorder due to the high risk of recurrent mania; Haloperidol is not recommended for maintenance.

Long-term maintenance therapy with a mood stabilizer is recommended in bipolar I disorder due to the high risk of recurrent mania; Haloperidol is not recommended for maintenance.

• A. Haloperidol is recommended for maintenance
• B. Atypical antipsychotics alone are sufficient for maintenance
• C. Mood stabilizer is recommended for maintenance; Haloperidol is not
• D. No maintenance therapy is needed

Answer: (C)

Long-term management of bipolar I aims to prevent relapses into mania and depression, since the risk of recurrence remains high even after an acute episode. The best way to achieve this prevention is with a mood stabilizer. Lithium, in particular, has strong evidence for reducing manic relapses and even suicide risk; other mood stabilizers like valproate or lamotrigine are used based on the patient’s history (valproate can help with rapid cycling; lamotrigine is more effective for long-term prevention of depressive episodes). Haloperidol, while useful for treating acute mania and agitation, is not favored for maintenance due to long-term side effects such as extrapyramidal symptoms and tardive dyskinesia, plus less convincing evidence for preventing relapses over years. Atypical antipsychotics can play a role in maintenance for some individuals, but they are not universally sufficient as monotherapy compared with mood stabilizers. Therefore, the recommended approach is to continue a mood stabilizer for maintenance and avoid relying on haloperidol for long-term prophylaxis.

Long-term management of bipolar I aims to prevent relapses into mania and depression, since the risk of recurrence remains high even after an acute episode. The best way to achieve this prevention is with a mood stabilizer. Lithium, in particular, has strong evidence for reducing manic relapses and even suicide risk; other mood stabilizers like valproate or lamotrigine are used based on the patient’s history (valproate can help with rapid cycling; lamotrigine is more effective for long-term prevention of depressive episodes).

Haloperidol, while useful for treating acute mania and agitation, is not favored for maintenance due to long-term side effects such as extrapyramidal symptoms and tardive dyskinesia, plus less convincing evidence for preventing relapses over years. Atypical antipsychotics can play a role in maintenance for some individuals, but they are not universally sufficient as monotherapy compared with mood stabilizers. Therefore, the recommended approach is to continue a mood stabilizer for maintenance and avoid relying on haloperidol for long-term prophylaxis.