There is also some evidence for the use of valproate and topiramate, although the results for the use of gabapentin have been disappointing. Antipsychotics
Antipsychotics are utilized as a second line option for hypomanic episodes, typically indicated patients who do not respond to mood stabilizers. However, quetiapine is the only antipsychotic that has demonstrated efficacy in multiple meta-analyses of Randomized controlled trials for treating acute BP-II depression, and is a first-line option for patients with BP-II depression. : 1697  Other antipsychotics that are used to treat BP-II include lurasidone, olanzapine, cariprazine, aripiprazole, asenapine, paliperidone, risperidone, ziprasidone, haloperidol, and chlorpromazine. As a class, the first generation antipsychotics are associated with movement disorders, along with anticholinergic side effects compared with second generation antipsychotics. Antidepressants
There is evidence to support the use of SSRI and SNRI antidepressants in BP-II, but the use of these treatments are controversial. Potential risks of antidepressant pharmacotherapy in patients with bipolar disorder include increased mood cycling, development of rapid cycling, dysphoria, and switch to hypomania. In addition, the evidence for their efficacy in bipolar depression is mixed. Thus, in most cases, antidepressant monotherapy in patients with BP-II is not recommended. However, antidepressants may provide benefit some patients when used in addition to mood stabilizers and antipsychotics, as these drugs reduce the risk of manic/hypomanic switching. However, the risk still exists, and should be used with caution. Non-pharmaceutical therapies
Although medication therapy is the standard of care for treatment of both BP-I and BP-II, additional non-pharmaceutical therapies can also help those with the illness.
ICD-11
According to the ICD-11, a BP-II patient will have experienced episodic experiences of one or more hypomaniac episodes and one or more major depressive episodes, and no history of a manic episode or mixed episode. These symptoms cannot be explained by other diagnoses such as

Cyclothymia
ADHD
Oppositional Defiant Disorder
Schizophrenia and other primary psychotic disorders
Substance-Use Disorder
Personality Disorders
Other Mental illness
Physical issues such as a brain tumorThe specifiers are the same as the DSM-5 with the exception of catatonic features and if symptoms have occurred with or without psychosis about 6 weeks after childbirth

Differential diagnoses
The signs and symptoms of BP-II may overlap significantly with those of other conditions. Thus, a comprehensive history, medication review, and laboratory work are key to diagnosing BP-II and differentiating it from other conditions. The differential diagnosis of BP-II is as follows: unipolar major depression, borderline personality disorder, posttraumatic stress disorder, substance use disorders, and attention deficit hyperactivity disorder. : 1653–7  In clinical practice, the difficulty of diagnosing BP-II depends on the accurate detection of hypomania, which is frequently dismissed by patients. Patients can present with increased productivity and energy with the absence of signs of instability or disturbance. As such, there is a risk that BP-II is misdiagnosed as generalized anxiety disorder or unipolar major depression. An accurate evaluation of differential diagnoses are crucial, as they guide treatment and prognostic implications.Major differences between BP-I and BP-II have been identified in their clinical features, comorbidity rates and family histories.