Efficacy of valproate versus lithium in mania or mixed mania
: a randomized, open 12-week trial.
And rather than the classic grandiosity and elation characteristic of adult mania, children with bipolar disorder tend to present with mixed mania
marked by irritability; agitation; and, sometimes, aggression.
They found that compared to non-substance abusers, substance-abusing bipolar patients were more likely to have frequent hospitalizations for affective symptoms, earlier onset of bipolar disorder, more rapid cycling, and more mixed mania
(the latter two considered to be the most severe, treatment-resistant forms of bipolar disorder).
* Electroconvulsive therapy (electroshock) is often helpful in the treatment of severe depression and/or mixed mania
that does not respond to medications.
(10) Relative to "pure" mania without mixed symptoms, mixed mania
occurs more frequently in women than men, and those with mixed mania
had a hospitalization at a younger age.