The current LAI antipsychotic. either dose optimization of the present LAI FGA or LAI SGA by escalating the dose when monitoring tolerance. or for LAI FGA: reduction of the time between 2 injections. Mixture of an oral antipsychotic using the current LAI antipsychotic. The discontinuation from the existing LAI antipsychotic and the switch to an oral antipsychotic within the acute phase is only advised as 2nd line technique.- Just after stabilization of your psychotic episodeIn the case of your mixture of an oral antipsychotic and an LAI antipsychotic inside the acute phase, optimizing the dose with the LAI antipsychotic and progressively discontinuing the oral antipsychotic even though monitoring the clinical state is advisable as the 1st line approach.Residual symptoms with LAI antipsychotics justifying a reassessmentIt is successively advised: in 1st line tactics: to optimize the remedy by LAI FGA or LAI SGA. by dose optimization of your existing LAI antipsychotic by MedChemExpress RIP2 kinase inhibitor 1 growing the dose when monitoring tolerance. or for LAI FGA: by decreasing the time between 2 injections. in 2nd line tactics. either through a combination of an oral antipsychotic together with the current LAI antipsychotic. or by changing the existing LAI FGA or LAI SGA for a further LAI antipsychotic (preferably a LAI SGA).It can be advised to continue as upkeep therapy the therapeutic approach that permitted the reduction of symptoms as well as the stabilization of your episode (approach of selection). In the case of a switch to an oral antipsychotic remedy through the acute phase, switching to an LAI formulation as upkeep treatment is recommended because the 1st line tactic.Llorca et al. BMC Psychiatry 2013, 13:340 http:www.biomedcentral.com1471-244X13Page 10 ofBipolar disorder Manic episode with LAI SGA-In the acute phase PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21310042 If monotherapy is ongoing, it truly is successively advised: in 1st line approach: to combine the existing LAI SGA with an oral anti-manic mood stabilizer (without recommendation of a certain medication). in 2nd line techniques. to optimize the dose with the existing LAI SGA by rising the dose whilst monitoring tolerance. or to discontinue the present LAI SGA and switch to an oral anti-manic mood stabilizer (without the need of recommendation of a particular medication). If bitherapy is ongoing (LAI SGA + lithium or anticonvulsant), it can be successively advisable: in 1st line method: to optimize the dose of the oral anti-manic mood stabilizer. in 2nd line methods. either to combine the current LAI SGA with an additional oral anti-manic mood stabilizer (with out recommendation of a specific medication). or to optimize the dose of your current LAI SGA by escalating the dose though monitoring tolerance. or to discontinue the existing LAI SGA and switch to a bitherapy of oral anti-manic mood stabilizers (without recommendation of a particular medication). or to continue the current treatment and mixture using a 2nd oral anti-manic mood stabilizer (devoid of recommendation of a certain medication). or to continue the current treatment and electroconvulsive therapy (ECT) administration.- Soon after stabilization of the manic episode either to optimize the dose of the present LAI SGA by escalating the dose while monitoring tolerance. or to combine the current LAI SGA with an oral antidepressant or with a series of ECT. or to discontinue the existing LAI SGA and switch to an oral mood stabilizer with antidepressant effect. If bitherapy is ongoing (LAI SGA + antidepressant), it can be s.