Even though lithium is still the choice drug in the treatment of bipolar disorder, recent studies have shown that it has a significant lower efficacy than previously described in earlier studies. Despite its adverse side effects, typical antipsychotic agents have often had a prominent role in the treatment of this psychiatric disorder, especially in the acute manic phase. Recently new alternatives have become available with the development of newer atypical antipsychotic agents. A comprehensive Medline search was conducted, and all available literature concerning the role of atypical antipsychotics in the treatment of bipolar patients was retrieved. Olanzapine showed to be quite effective in the treatment of acute mania, and it was found that an average of 63.5% of the patients had a significant improvement in double blind controlled studies, with weight gain as the major side effect. 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