The dopaminergic, noradrenergic, serotoninergic and GABA-ergic imbalances as well as the kindling phenomena lead to a particular therapeutic approach for the bipolar affective disorder.

The therapeutic management aims both at prolonged remissions, and at the prevention of mood veering.

Evaluating the efficacy of using atypical antipsychotic substances with and without the association of mood-stabilizing substances in the favourable evolution of the disorder.

The study included two groups of patients with bipolar affective disorder (according to DSM-IV criteria) in the period 2009–2011.

Group A (n=28) was treated with quetiapinum 600mg /day, while group B (n=30) with quetiapinum 600mg/day together with valproat 1500mg/day, during the study period, with evalution through MADRAS, CGI, YMRS scales.

Remission was obtained in both groups, within sensibly equal time.

In group A(quetiapinum), 7,15% of patients presented mood veering (from anger to depression), 42,7% relapsed within the first 12 months, and 7,15% had at least 4 depressive episodes in 12 months. Remission was not maintained in any of the patients during the study period.

In group B (quetipinum+valproat) remission had longer duration for 80% (over 18 months), 20% didn’t have any decompensation, and no mood veering was recorded.

The association of mood-stabilizers in the treatment with atypical antipsychotic substances led to remissions with long duration.

The use of mood-stabilizers in the treatment of bipolar affective disorder prevents mood veering and avoids the disorder evolution towards a rapid cycling form.