For the outcome “manic switch”, all investigated medicines were not convincingly different than placebo. However, these data were mainly from short-term studies. Generally, manic switch seems to be a rare complication.

The European Medical Agency (EMA) recommends avoiding sodium valproate in pregnancy and that it should not be used in the absence of pregnancy prevention programmes. For mania, teratogenicity is problematic as the condition leads to impaired judgement and an increase in risky promiscuous behaviour

Maintenance therapy with antipsychotic was significantly superior to discontinuation with a follow-up of up to 12 months as well as up to 24 months(extracted from three systematic reviews)

Maintenance therapy with antipsychotic was significantly superior to discontinuation with a follow-up of up to 12 months as well as up to 24 months(extracted from three systematic reviews)

Baclofen decreases the risk of relapse into any drinking(Systematic review from Abagio etc Al., 2023. Doi:10.1002/14651858.CD012557.pub3)

New Mental Health Gap Action
Programme (mhGAP)
guideline for mental,
neurological and
substance use disorders(www.who.int/publications...)