Antidepressants include selective serotonin reuptake inhibitors (SSRI’s), mono-amine oxidase inhibitors (MAOI’s) and tricyclic antidepressants (TCA’s). These antidepressants maintain adequate levels of serotonin and norepinephrine in the synaptic terminals. Mood stabilizers like lithium, valproic acid and carbamezapine are used for treatment of mania or bipolar disorder. The exact mechanism of action of these drugs by which they control mania is unknown. Anxiolytics like benzodiazepines are used in the treatment of different anxiety disorders.
ECT is mainly used as treatment of depression. During ECT, a current is passed through the electrodes and seizure activity is generated in the brain. After a few cycles of ECT, symptoms of patients get better.
Psychosurgery is mostly used as an experimental modality these days and involves brain surgery where connections between different parts of the brain are cut to improve abnormal behavior. This is only considered in cases which are refractory to treatment.
In a nutshell, according to the biological theory, bipolar disorder is a multifactorial disease involving genetic predisposition, disturbance in neurotransmitters and structural defects in the brain. This disease runs in families and monozygotic twins have a higher risk of developing bipolar disorder as compared to dizygotic twins. Mood stabilizers like lithium are the most effective treatment modalities available.