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The preferred strategy is to give ECT while also administering mood-stabilizing medications; the drugs help to prevent acute relapse. ECT is considered a treatment of last resort, primarily because of the costs involved, but it remains an important and often lifesaving technique for treating both manias and severe depressions of bipolar illness.

Once the current manic episode is completely controlled, it is common practice to continue medications, even though there are no obvious symptoms.

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