Hierarchical ranking of first-line treatments for the management of manic episodes, with suggested starting doses - McMaster Textbook of Internal Medicine South Asian Ed.

Table 16.6-1. Hierarchical ranking of first-line treatments for the management of manic episodes, with suggested starting doses
Drug	Dosage
First-line monotherapies
Lithium	300-600 mg/d; final dosage depends on serum medication levels, clinical response, and age (see text)
Quetiapine	100 mg/d and increasing daily by 100 mg to a total of 600-800 mg/d
Divalproex	250-500 mg/d (target 1000-1500 mg/d)
Asenapine	5 mg bid (target 5-10 mg bid)
Aripiprazole	15 mg/d (target 15-30 mg/d)
Paliperidone	3 mg/d (target 6-12 mg/d)
Risperidone	2-3 mg/d (target 2-4 mg/d)
Cariprazine	Day 1: 1.5 mg/d; day 2+: 3 mg/d
First-line combination therapies
Quetiapine + lithium/divalproex	See above
Aripiprazole + lithium/divalproex	See above
Risperidone + lithium/divalproex	See above
Asenapine + lithium/divalproex	See above