Bipolar disorder affects around 8 million adults in the US and 40 million people worldwide. The age of onset typically occurs between 15 and 25 years, and early diagnosis and treatment can lead to a more favorable prognosis. However, diagnosis and treatment are often delayed by about 9 years after the first depressive episode. Long-term treatment involves mood stabilizers like lithium, valproate, and lamotrigine, along with antipsychotics such as quetiapine, aripiprazole, and cariprazine. While antidepressants are not recommended as monotherapy, adherence to treatment remains a challenge, with over 50% of patients not following prescribed regimens.

People with bipolar disorder have a reduced life expectancy by 12 to 14 years and face increased cardiovascular risks, with a twofold higher mortality rate. Conditions such as metabolic syndrome, obesity, smoking, and type 2 diabetes are more prevalent in individuals with bipolar disorder, contributing to early mortality. The annual suicide rate is approximately 0.9%, significantly higher than the general population’s rate of 0.014%, and about 15% to 20% of individuals with bipolar disorder die by suicide. Despite these challenges, first-line therapy typically includes mood stabilizers, anticonvulsants, and atypical antipsychotics to manage the disorder’s symptoms and improve quality of life.

Reference: Nierenberg AA, Agustini B, Köhler-Forsberg O, et al. Diagnosis and Treatment of Bipolar Disorder: A Review. JAMA. 2023 Oct 10;330(14):1370-1380. doi: 10.1001/jama.2023.18588. PMID: 37815563.