International Journal of Research & Review (www.ijrrjournal.com) 432 Vol.6; Issue: 11; November 2019 International Journal of Research and Review www.ijrrjournal.com E-ISSN: 2349-9788; P-ISSN: 2454-2237 Review Article New Approaches in the Treatment of Bipolar Disorder Sharol PS 1 , Mebin Alias 2 , R. Sambathkumar 2 1 Post Graduate Student, 2 Lecturer, Department of Pharmacy Practice, J.K.K Nattraja college of Pharmacy, Komarapalayam, Tamil Nadu, India. Corresponding Author: Sharol PS ABSTRACT Bipolar disorder is classically delineated as clinically vital episodes of depression and elevated mood with intervening periods of traditional mood. Bipolar depression remains a treatment challenge, with remission rates of solely twenty five to sixty p.c once counseled treatment. Until recently, only quetiapine, olanzapine and fluoxetine were approved to treat bipolar depression. Treatment typically has a pair of phases. Acute-phase treatment is concentrated on the management of the acute mood episodes (manic, hypomanic, or depressive). Maintenance-phase treatment is concentrated on preventing recurrences of acute episodes. In acute treatment settings, patients with bipolar disorders may present with severe agitation, violent behaviors, and psychosis. When this occurs, the goal of treatment is to control dangerous behaviors that may result in harm to the patient or others. Patients can then be safely interviewed and further evaluated. Oral or inhaled pharmacotherapy with benzodiazepines or antipsychotic drugs can be offered to agitated but cooperative patients. However, parenteral antipsychotics, with or without benzodiazepines, may be needed to quickly manage aggressive and violent behaviors. The goal of acute treatment for bipolar depressive episodes is remission. Because remission requires several weeks to occur, a reasonable interim goal is response, defined as a suicidal ideation and psychotic features. Improvement in depressive symptoms must occur without precipitating manic episodes or rapid cycling. Keywords: Depression, Bipolar disorder, psychosis, violent behaviors, pharmacotherapy, manic episodes INTRODUCTION Bipolar disorder is classically delineated as clinically vital episodes of depression and elevated mood with intervening periods of traditional mood. Bipolar depression happens in close to one- hundredth of the globe population and is outlined as a serious depressive episode in patients United Nations agency have toughened a minimum of one episode of mania or hypomania. In most patients with wild depressive unwellness, depressive episodes predominate in frequency and severity; consequently, many patients initially hunt for treatment for depression. [1] Bipolar depression remains a treatment challenge, with remission rates of solely twenty five to sixty p.c once counseled treatment. [5] Until recently, only quetiapine, olanzapine and fluoxetine were approved to treat bipolar depression [2] like different atypical antipsychotics, it antagonizes Dopastat D2 receptors, still as monoamine neurotransmitter 5-HT2A and 5-HT7 receptors. [3,4] monoamine neurotransmitter, noradrenaline, and Dopastat is that the cornerstone of antidepressant drug pharmacotherapy Lurasidone could exert antidepressant drug effects by increasing Dopastat activity within the anterior cortex