First-line treatment of mania is?

Appeared in: UPPSC-2021

Explanation

Lithium is the gold-standard and first-line mood stabilizer for treating acute mania, particularly classic euphoric mania.
It works to stabilize mood and prevent relapses in bipolar disorder, though its full therapeutic effect may take 1-2 weeks to develop.
While effective, it has a narrow therapeutic index, requiring close monitoring of serum levels to prevent toxicity and ensure patient safety.

Why Other Options Were Wrong

Option A: Benzodiazepines are used as adjunctive therapy to manage agitation, insomnia, or anxiety in acute mania but do not treat the underlying mood disturbance.
Option B: Haloperidol is an antipsychotic used for rapid control of severe agitation or psychosis in mania, but it is not a first-line mood stabilizer for long-term treatment.
Option D: This option is incorrect because a correct first-line treatment (Lithium) is listed among the choices.

Related Visual

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of acute mania helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The nurse's primary role in lithium therapy is vigilant monitoring for signs of toxicity (e.g., coarse tremors, vomiting, confusion), as the therapeutic window is very narrow.
Patient education is critical for safety, including the importance of maintaining consistent salt and fluid intake, avoiding NSAIDs, and knowing which symptoms to report immediately.
What if? If a patient presents with severe renal impairment, lithium would be contraindicated or used with extreme caution. An alternative like valproate or an atypical antipsychotic would likely become the first-line choice.

How to Approach the Question

First, identify the core of the question: it asks for the 'first-line treatment' for 'mania'.
This is a factual recall question requiring knowledge of psychopharmacology.
Scan the options: Benzodiazepine, Haloperidol, Lithium.
Evaluate each option's primary drug class and use. Benzodiazepines are anxiolytics/sedatives. Haloperidol is an antipsychotic. Lithium is a mood stabilizer.
Recall that mood stabilizers are the cornerstone of mania treatment. Lithium is the classic and primary example, making it the 'first-line' choice for this condition.

Concept Tested & Keywords

Concept Tested: Pharmacological management of acute mania
Stem keywords: First-line treatment, mania
Lead-in keywords: is
Negative lead-in flag: false

Question ID

QgEuxwRYZX0iiyxxFB5OOV

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 5563-5565

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1197-1199

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 271-273

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