Mixed states are characterized by the coexistence of manic and depressive symptoms in the same mood episode. In clinical practice, identification of such states is essential.

The study's purpose was to evaluate our clinical practice for the treatment of mixed access and compare with international recommendations.

This is a retrospective study of the records of patients with bipolar disorder, mixed access hospitalized in our department from August 2009 to January 2012.

The sex ratio was 0.52 (23 men / 22 women.). The average age was 39.4 years. In the majority of patients, treatment of mixed episode was based on a combination of drugs. Prescribed combinations were: Conventional neuroleptic (haloperidol) and antiepileptic (valoproique acid) in 44% of cases, haloperidol and antiepileptic (carbamazepine) in 24%, Atypical antipsychotic (Olanzapine) and antiepileptic (valoproique acid) in 16% of cases.- Atypical antipsychotic (risperidone) and valoproique acid in 8% - olanzapine was prescribed as monotherapy In 8% cases

Our therapeutic conduct is in compliance with the international recommendations.

The occurrence of mixed episodes is often associated with poor response to treatment, greater recurrence of episodes and a higher risk of suicide. The recognition of these conditions and the use of appropriate treatment are needed to improve the prognosis of the disease.