With the advent of randomized clinical trials to prove efficacy for psychiatric treatment, it was necessary to devise methods to measure clinical outcomes and conceptualize remission also in bipolar disorder. At the beggining comorbidity and gender differences in course of the illness are discussed. Further this article details the pharmacotherapy. At first general recommendation for the treatment of bipolar disorder and criteria for individual choice are summarized. Recent views on treatment of mania, bipolar depression and maintenance treatment are reviewed. Finally the side effects problematic during maintenance treatment are mentioned. In near future answers for questions important in clinical practice should be found: What treatment is optimal for individual patient? What is the place of atypical antipsychotics in the treatment of bipolar disorder? How to resist the economic pressure and ensure availability of optimal known treatment for most of the patients?

Keywords: bipolar disorder, gender differences, mania, bipolar disorder, acute treatment, maintenance treatment