Manic episodes are treated with lithium and a neuroleptic.  Bipolar disorders are treated with lithium.

Patients with fast-cycling bipolar disorder (>2 cycles per year) do not respond to lithium.  Instead, use neuroleptics (ex: chlorpromazine), valproate, or carbamazepine.

Valproate is probably the more effective of these alternatives for the fast cyclers!

Lithium causes tremors, sedation, and at high doses mental confusion.

It is associated with weight gain and goiter.

It can cause nodal block in the heart and sinus bradycardia.

Leukocytosis may also occur.

In overdoses, lithium causes seizures, coarse tremors, coma, and cardiovascular collapse.

It is a category D drug.  AVOID IN PREGNANCY.

Valproic acid is an anticonvulsive drug.  It can be administered as prophylaxis alongside other drugs that reduce the seizure threshold (neuroleptics, SSRIs).

It is also used with lithium in the treatment of bipolar disorder.  It is especially usful in rapid cycling bipolar patients.

Carbamazepine is an anticonvulsant drug.  It is a second line drug in the treatment of bipolar disorder.  Try it if lithium does not work.

It has a structure similar to the TCADs, so its toxicities are also similar, namely cardiotoxicity.

Hypomania is considered a separate disease altogether from mania.  It is often treated with neuroleptics, but lithium also finds some use here.

Pure mania also responds to both lithium or neuroleptics.

Lamotrigine is used to treat bipolar disorder.

Carbamazepine stimulates the metabolism of lamotrigine, so increase the dose of lamotrigine

these are both drugs used in the treatment of bipolar disorder.