Pharmacologic loading in the treatment of acute mania

The rapid and safe reduction of manic symptoms is an important initial goal of the pharmacologic treatment of acute mania. The pharmacokinetics and st udies of pharmacologic loading of lithium, valproate, and carbamazepine wer e reviewed. In addition, the feasibility of administering other agents with potential efficacy in mania, e.g., atypical antipsychotics and new anticon vulsants, was discussed. Further double-blind, controlled studies with adeq uate sample sizes comparing loading strategies with more gradual titration schedules of candidate antimanic agents are needed.