The existing LAI antipsychotic. either dose optimization of your existing LAI FGA or LAI SGA by rising the dose though monitoring tolerance. or for LAI FGA: reduction with the time among two injections. Combination of an oral antipsychotic with all the present LAI antipsychotic. The discontinuation with the existing LAI antipsychotic plus the switch to an oral antipsychotic inside the acute phase is only suggested as 2nd line method.- Right after stabilization of the psychotic episodeIn the case with the mixture of an oral antipsychotic and an LAI antipsychotic in the acute phase, optimizing the dose with the LAI antipsychotic and progressively discontinuing the oral antipsychotic when monitoring the clinical state is recommended as the 1st line approach.Residual symptoms with LAI antipsychotics justifying a reassessmentIt is successively encouraged: in 1st line approaches: to optimize the therapy by LAI FGA or LAI SGA. by dose optimization of your present LAI antipsychotic by growing the dose though monitoring tolerance. or for LAI FGA: by lowering the time involving two injections. in 2nd line approaches. either through a mixture of an oral antipsychotic together with the existing LAI antipsychotic. or by changing the current LAI FGA or LAI SGA for one more LAI antipsychotic (preferably a LAI SGA).It is actually advised to continue as maintenance treatment the therapeutic method that permitted the reduction of symptoms and the stabilization in the episode (technique of option). Inside the case of a switch to an oral antipsychotic remedy during the acute phase, switching to an LAI formulation as maintenance remedy is suggested as the 1st line approach.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 is successively suggested: in 1st line technique: to combine the current LAI SGA with an oral anti-manic mood stabilizer (with out recommendation of a distinct D-3263 (hydrochloride) medication). in 2nd line tactics. to optimize the dose of your present LAI SGA by rising the dose when monitoring tolerance. or to discontinue the current LAI SGA and switch to an oral anti-manic mood stabilizer (with out recommendation of a particular medication). If bitherapy is ongoing (LAI SGA + lithium or anticonvulsant), it is successively advised: in 1st line tactic: to optimize the dose with the oral anti-manic mood stabilizer. in 2nd line techniques. either to combine the current LAI SGA with another oral anti-manic mood stabilizer (with no recommendation of a specific medication). or to optimize the dose of the present LAI SGA by growing the dose while monitoring tolerance. or to discontinue the current LAI SGA and switch to a bitherapy of oral anti-manic mood stabilizers (devoid of recommendation of a distinct medication). or to continue the current therapy and mixture with a 2nd oral anti-manic mood stabilizer (with no recommendation of a particular medication). or to continue the existing treatment and electroconvulsive therapy (ECT) administration.- Soon after stabilization of the manic episode either to optimize the dose from the current LAI SGA by growing the dose while monitoring tolerance. or to combine the present LAI SGA with an oral antidepressant or with a series of ECT. or to discontinue the present LAI SGA and switch to an oral mood stabilizer with antidepressant impact. If bitherapy is ongoing (LAI SGA + antidepressant), it truly is s.