For patients experiencing acute manic episodes in bipolar disorder, which medication is often the first-line treatment?

Lithium is often the first-line treatment for patients experiencing acute manic episodes in bipolar disorder because of its proven efficacy in reducing manic symptoms and preventing both manic and depressive episodes. Lithium stabilizes mood by influencing neurotransmitter levels and enhancing the activity of certain neuroprotective factors in the brain, which helps regulate mood more effectively.

Carbamazepine and lamotrigine are also used in the management of bipolar disorder but are not considered first-line treatments for acute mania. Carbamazepine can be effective, particularly in patients who have not responded to lithium, while lamotrigine is more effective for the depressive phase and is not typically used for acute mania. Venlafaxine, an antidepressant, is not appropriate for treating acute mania and may even exacerbate manic symptoms if used in bipolar patients without mood stabilizers.

Thus, lithium’s well-established role in managing acute mania makes it the most appropriate choice for first-line treatment in this scenario.