Analysis of the treatment alternatives for patients diagnosed with a bipolar disorder of torpid evolution. Revision of the possible adverse effects of lithium and its impact on the adherence to treatment.

We revise the clinical evolution of a patient diagnosed with Bipolar disorder type I, with the following characteristics: at least two maniac episodes per year, consumption of toxic substances and high sensibility to antipsychotics and euthymics.

We will describe the case of a 23-years-old patient diagnosed with bipolar disorder type I. During the course of the illness, benign intracranial hypertension is diagnosed and the treatment with lithium must be stopped. We replace lithium treatment by Asenapine monotherapy. The evolution of the patient was very positive. Taking account of the adverse effects of lithium and reducing them can facilitate the adherence to treatment and also benefit early remission and less deterioration in each episode.

It is fundamental to promote a comprehensive approach to each patient, including psychotherapy, psychoeducation as well as appropriate medication. The knowledge of the described effects helps us to determinate the appropriate medication for each patient.

The authors have not supplied their declaration of competing interest.