What is considered the drug of choice for maintenance treatment of bipolar disorder?

Lithium is recognized as the drug of choice for the maintenance treatment of bipolar disorder due to its efficacy in stabilizing mood and preventing both manic and depressive episodes. It has been used for decades and has a strong evidence base supporting its use in long-term management.

One of the key factors contributing to lithium's status as the first-line treatment is its ability to reduce the risk of recurrence in individuals with bipolar disorder, making it particularly effective for maintaining stability after a manic or depressive episode. Additionally, lithium has shown proven long-term benefits in reducing the overall incidence of suicidal behavior among patients with bipolar disorder.

While other medications, such as valproic acid, lamotrigine, and carbamazepine, are also utilized in the management of bipolar disorder, they are often considered alternatives or adjuncts rather than first-line treatments for maintenance therapy. Each of these medications can be effective for specific cases or phases of the disorder, but lithium remains the standard treatment for maintaining mood stability over time.