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The majority of relapses were caused by manic rather than depressive symptoms; based on patient history, patients enrolled in the study had more manic episodes than depressive episodes. Continuation of IM risperidone therapy in addition to mood stabilizers delayed time to relapse to any mood episode depression, mania, hypomania, or mixed compared with placebo; the relapses were approximately half depressive and half manic or mixed episodes in this study.

For the initial management of less severe manic or mixed episodes in patients with bipolar disorder, current APA recommendations state that monotherapy with lithium, valproate e.

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