Table 16.6-2. Hierarchical ranking of first-line maintenance treatments in bipolar disorder, with suggested starting doses

Drug

Dosage

Lithium

Typically 600-1200 mg/d depending on serum medication levels

Quetiapine

Typically 300-600 mg/d

Divalproex

Typically 1000-1500 mg/d

Lamotrigine

100-300 mg/d

Asenapine

5 mg bid

Aripiprazole

5-30 mg/d

Quetiapine + lithium/divalproex

See above

Aripiprazole + lithium/divalproex

See above

Aripiprazole OM

400 mg every 3-4 weeks

OM, once monthly.