Clinical Updates and Efficacy of Mood Stabilizers in the Treatment of Type I Bipolar Disorder

Background: Bipolar I disorder (BD-I) is a severe chronic psychiatric condition associated with high mortality, psychosocial impairment, and various comorbidities. It is characterized by episodes of mania, depression, and mixed states, and is associated with a high suicide rate. Long-term management is predominantly carried out with mood stabilizers, such as lithium or sodium valproate, combined with second-generation antipsychotics as first-line treatment. In addition, psychotherapy and psychosocial interventions constitute effective adjunctive strategies for the long-term control of the disorder. Objective: To evaluate the efficacy of mood stabilizers in the treatment of Bipolar I Disorder (BID) and to review the main clinical updates regarding the pharmacological and non-pharmacological management of this condition. Methodology: A narrative literature review focused on the critical analysis of recent scientific evidence regarding the treatment and therapeutic management of BID. Results: Lithium remains the gold standard for the treatment of Bipolar I Disorder (BID), proving particularly effective in inducing remission and maintaining remission from manic and depressive episodes, as well as reducing the risk of suicide. Recent updates emphasize the contraindication and severe restrictions regarding valproate in women of childbearing age due to the high teratogenic risk. Contemporary literature confirms the superiority of the combination of mood stabilizers and second-generation antipsychotics, coupled with rigorous metabolic monitoring and the incorporation of structured psychotherapies. Conclusion: Although classic mood stabilizers have proven efficacy, current clinical guidelines reinforce the need for individualized treatment planning that balances efficacy, tolerability, adverse effect profiles, and psychosocial interventions aimed at patient-centered care.