L. Majorité, échantillon a plus de 30 ans et il s'agit d'une population majoritairement féminine (figures 1 et 2) Dans la littérature, le sexe ratio retrouvé pour les troubles bipolaires est de 1, alors que dans cette étude, il s'élève à 1

. La-moyenne-d, âge de 45 ans a également été retrouvée dans une étude conduite en France sur 137 patients bipolaires hospitalisés pour épisode maniaque durant les 3 mois qui ont suivis leur hospitalisation 13 ?

C. Au and . De, Saint-Egrève, l'âge moyen est de 41 ans et la population est majoritairement masculine (58 % d'hommes)

M. Caire and K. Lozinski, De la PMD aux troubles bipolaires. L'encéphale, pp.3-7, 2005.

P. Chiaroni, Aspects cliniques et diagnostic des troubles bipolaires, La revue du praticien, vol.55, pp.493-499, 2005.

C. Gay, Troubles bipolaires de l'humeur. La revue du praticien, pp.479-485, 2005.

J. Alliaire, E. Hantouche, and D. Sechter, Fréquence et aspects cliniques du trouble bipolaire II dans une étude multicentrique française : EPIDEP. L'encéphale, pp.149-158, 2001.

F. Godwuin and J. K. , Manic-Depressive Illness, 1990.

C. Murray and A. Lapez, Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study, The Lancet, vol.349, issue.9063, pp.1436-1442, 1997.
DOI : 10.1016/S0140-6736(96)07495-8

E. Lipski and F. Baylé, Troubles bipolaires et comorbidité psychiatrique, La revue du praticien, vol.55, pp.501-506, 2005.

M. Freeman, S. Freeman, M. Elroy, and S. , The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues, Journal of Affective Disorders, vol.68, issue.1, pp.1-23, 2002.
DOI : 10.1016/S0165-0327(00)00299-8

C. Zarate, . Jr, M. Tohen, and M. Banov, Is clozapine a mood stabilizer ?, J Clin Psychiatry, vol.56, issue.3, pp.108-112, 1995.

S. Gupta, P. S. Franck, and B. , Topiramate in Bipolar and Schizoaffective Disorders, The Primary Care Companion to The Journal of Clinical Psychiatry, vol.02, issue.03, pp.96-100, 2000.
DOI : 10.4088/PCC.v02n0304

J. R. Calabrese and C. L. Bowden, Spectrum of Activity of Lamotrigine in Treatrnent- Refractoy Bipolar disorder, Arn J Psychiatry, vol.156, pp.1019-1023, 1999.

L. Altshuler and R. Post, Antidepressant-induced mania and cycle acceleration: a contreversy revisited, Arn J Psychiatry, issue.8, pp.152-1130, 1995.

M. A. Robert, . Hirschfield, C. Bowden, and M. Gitlin, Practice Guideline for the treatrnent of Patients With Bipolar Disorder (Revision), Am J Psychiatry, vol.159, issue.4, pp.1-15, 2002.

C. Correll, S. Leucht, and J. Kane, Lower Risk for Tardive Dyskinesia Associated With Second-Generation Antipsychotics: A Systematic Review of 1-Year Studies, American Journal of Psychiatry, vol.161, issue.3, pp.414-425, 2004.
DOI : 10.1176/appi.ajp.161.3.414

F. Petitjean, Recommandation de la British Association for Psychopharrnacology pour le traitement du trouble bipolaire, Act. Med. Int, pp.1-8, 2004.

T. Suppes, E. Dennehy, and L. Altshuler, The Texas Implementation of Medication Algorithms, The Journal of Clinical Psychiatry, vol.66, issue.07, pp.870-886, 2005.
DOI : 10.4088/JCP.v66n0710

E. Keck, R. Marcus, and S. Tourkodimitris, A Placebo-Controlled, Double-Blind Study of the Efficacy and Safety of Aripiprazole in Patients With Acute Bipolar Mania, American Journal of Psychiatry, vol.160, issue.9, pp.1651-1658, 2003.
DOI : 10.1176/appi.ajp.160.9.1651

E. Vieta, M. Bourin, and S. Retal, Effectiveness of aripiprazole v. haloperidol in acute bipolar mania: Double-blind, randomised, comparative 12-week trial, The British Journal of Psychiatry, vol.187, issue.3, pp.235-242, 2005.
DOI : 10.1192/bjp.187.3.235

J. Aubry, Médications et troubles bipolaires Santé mentale, pp.28-35, 2004.

C. Gay and J. Olié, Prise en charge des troubles bipolaires, La revue du praticien, vol.55, pp.513-522, 2005.

A. Beydun, Clinical use of tricyclic anticonvulsivants in painful neuropathies and bipolar disorders. Epilepsy &::; Behaviour, pp.18-22, 2002.

M. Tohen, T. Jacobs, and S. Grundy, Efficacy of Olanzapine in Acute Bipolar Mania<subtitle>A Double-blind, Placebo-Controlled Study</subtitle>, Archives of General Psychiatry, vol.57, issue.9, pp.841-849, 2000.
DOI : 10.1001/archpsyc.57.9.841

P. Tran, G. Tollefson, and T. Sanger, Olanzapine versus haloperidol in the treatment of schizoaffective disorder. Acute and long-term therapy, The British Journal of Psychiatry, vol.174, issue.1, pp.15-22, 1999.
DOI : 10.1192/bjp.174.1.15

M. Tohen, J. Goldberg, G. Arrillaga, and A. , A 12-Week, Double-blind Comparison of Olanzapine vs Haloperidol in the Treatment of Acute Mania, Archives of General Psychiatry, vol.60, issue.12, pp.1218-1226, 2003.
DOI : 10.1001/archpsyc.60.12.1218

M. Tohen, R. Baker, and L. Altshuler, Olanzapine versus divalproex in the treatment of acute mania. AmericanjJournal of psychiatry, pp.1011-1017, 2002.

R. Baker, E. Brown, and H. Akiskal, Efficacy of Olanzapine combined with valproate or lithium in the treatment of dysphorie mania, British Journal of psychiatry, vol.185, pp.4-72, 2004.

M. Tohen, C. Waternaux, and M. Tsuang, Outcome in Mania, Archives of General Psychiatry, vol.47, issue.12, pp.1106-1111, 1990.
DOI : 10.1001/archpsyc.1990.01810240026005

M. Tohen, J. Calabrese, and M. Banov, Randomized, Placebo-Controlled Trial of Olanzapine as Maintenance Therapy in Patients With Bipolar I Disorder Responding to Acute Treatment With Olanzapine, American Journal of Psychiatry, vol.163, issue.2, pp.247-256, 2006.
DOI : 10.1176/appi.ajp.163.2.247

M. Tohen, G. Waldemar, and J. Calabrese, Olanzapine Versus Lithium in the Maintenance Treatment of Bipolar Disorder: A 12-Month, Randomized, Double-Blind, Controlled Clinical Trial, American Journal of Psychiatry, vol.162, issue.7, pp.1281-1290, 2005.
DOI : 10.1176/appi.ajp.162.7.1281

M. Tohen, E. Vieta, and J. Calabrese, Efficacy of Olanzapine and Olanzapine-Fluoxetine Combination in the Treatment of Bipolar I Depression, Archives of General Psychiatry, vol.60, issue.11, pp.1079-1088, 2003.
DOI : 10.1001/archpsyc.60.11.1079

S. Khanna, E. Vieta, and B. Lyons, Risperidone in the treatment of acute mania: Double-blind, placebo-controlled study, The British Journal of Psychiatry, vol.187, issue.3, pp.229-234, 2005.
DOI : 10.1192/bjp.187.3.229

G. S. Sachs, F. Grossman, and G. S. , Combination of a Mood Stabilizer With Risperidone or Haloperidol for Treatment of Acute Mania: A Double-Blind, Placebo-Controlled Comparison of Efficacy and Safety, American Journal of Psychiatry, vol.159, issue.7, pp.1146-1154, 2002.
DOI : 10.1176/appi.ajp.159.7.1146

P. Masand, X. Wang, and S. Gupta, Comparison of Risperidone and Olanzapine in Bipolar and Schizoaffective Disorders, The Primary Care Companion to The Journal of Clinical Psychiatry, vol.04, issue.02, pp.70-73, 2002.
DOI : 10.4088/PCC.v04n0205

C. Guille, G. Sachs, and S. Ghaemi, A Naturalistic Comparison of Clozapine, Risperidone, and Olanzapine in the Treatment of Bipolar Disorder, The Journal of Clinical Psychiatry, vol.61, issue.9, pp.61-638, 2000.
DOI : 10.4088/JCP.v61n0907

A. Gelenberg and H. Hopkins, Treating bipolar disorder : Toward the Third Millenium, Psychiatrie Times, issue.4, p.13, 2001.

W. Greil and . Kleindienstn, Lithium versus carbamazepine in the maintenance treatment of bipolar II disorder and bipolar disorder not otherwise specified, International Clinical Psychopharmacology, vol.14, issue.5, pp.283-285, 1999.
DOI : 10.1097/00004850-199914050-00003

W. Greil, W. Ludwig-mayerhofer, and N. Erazo, Lithium versus carbamazepine in the maintenance treatment of bipolar disorders ??? a randomised study, Journal of Affective Disorders, vol.43, issue.2, pp.151-161, 1997.
DOI : 10.1016/S0165-0327(96)01427-9

S. Mcelroy, P. Keck, . Jr, and S. Strakowski, Mania, psychosis, and antipsychotics, J Clin Psychiatry, vol.57, issue.3, pp.47-49, 1996.

J. Hawkins, K. Acher, and S. Strakowski, Somatic Treatment of Catatonia, The International Journal of Psychiatry in Medicine, vol.3, issue.4, pp.345-369, 1995.
DOI : 10.2190/X0FF-VU7G-QQP7-L5V7

G. Bush, M. Pink, G. Petrides, and . Catatonia, Catatonia. II. Treatment with lorazepam and electroconvulsive therapy, Acta Psychiatrica Scandinavica, vol.145, issue.3, pp.93-137, 1996.
DOI : 10.1016/0163-8343(91)90024-Q

L. Tondo and R. Baldessarini, Reduced suicide risk during lithium maintenance treatment, J Clin Psychiatry, issue.9, pp.61-97, 2000.

G. Sachs, F. Grossman, and S. Ghaemi, Combination of a Mood Stabilizer With Risperidone or Haloperidol for Treatment of Acute Mania: A Double-Blind, Placebo-Controlled Comparison of Efficacy and Safety, American Journal of Psychiatry, vol.159, issue.7, pp.1146-1154, 2002.
DOI : 10.1176/appi.ajp.159.7.1146

M. Tohen, K. Chengappa, and P. Suppes, Efficacy of Olanzapine in Combination With Valproate or Lithium in the Treatment of Mania in Patients Partially Nonresponsive to Valproate or Lithium Monotherapy, Archives of General Psychiatry, vol.59, issue.1, pp.62-69, 2002.
DOI : 10.1001/archpsyc.59.1.62

M. Tohen, K. Chengappa, and P. Suppes, Olanzapine combined with lithium or valproate for relapse prevention of bipolar disorder : an 18-month study, Presented at the 155 th annual meeting of the American psychiatrie Association, 2002.

G. Sachs, D. Printz, D. Kahn, D. Carpenter, and J. Docherty, The expert consensus guidelines series. Medication treatment of bipolar disorder, 2000.

I. Salloum and M. Thase, Impact of substance abuse on the course and treatment of bipolar disorder, Bipolar Disorders, vol.2, issue.3.2, pp.269-280, 2000.
DOI : 10.1034/j.1399-5618.2000.20308.x

D. Deutschman, D. Deutschman, and J. Chalekian, Oxcarbazépine Efficacy and safety in Bipolar Disorder : review of 249 patients, Fith International Conference on Bipolar Disorder, 2003.

H. Emrich, H. Altmann, and M. Dose, Therapeutic effects of GABA-ergic drugs in affective disorders. A preliminary Report, Pharmacology Biochemistry and Behavior, vol.19, issue.2, pp.369-72, 1983.
DOI : 10.1016/0091-3057(83)90067-9

J. Faigle and G. Menge, Trileptal) and their Beneficial Implications for Enzyme Induction and Drug Interactions, Behavioural Neurology, vol.3, issue.1, pp.21-30, 1990.
DOI : 10.1155/1990/917164

Y. Berdsudsky, Phenytoin: an anti-bipolar anticonvulsant?, The International Journal of Neuropsychopharmacology, vol.9, issue.04, pp.479-484, 2006.
DOI : 10.1017/S1461145705006140

C. Henry and C. Gay, Etat de la recherche des troubles bipolaires, Encyclopédie Orphanet, 2004.

G. Parker, N. Gibson, and H. Brotchie, Omega-3 Fatty Acids and Mood Disorders, American Journal of Psychiatry, vol.163, issue.6, pp.969-978, 2006.
DOI : 10.1176/ajp.2006.163.6.969