To observe the efficacy and side effects of combining Visteon and clozapine with lithium carbonate respectively in the treatment of bipolar disorder. The author randomly divided 60 bipolar patients who met the diagnostic criteria of CCMD-2-R into 2 groups, and combined Visteon or clozapine on the basis of lithium carbonate for a period of 6 weeks. The efficacy was assessed using the Mania Scale and Total Clinical Efficacy Scale, and the side effects were assessed using the TESS. The results showed that the efficacy of the Visteon group and the clozapine group were comparable, with the total effective rates of 90%, 93%, and 3%, respectively, and the onset of action of the Visteon group was later than that of the clozapine group, but the side-effects were milder, and the adherence was good. Conclusion: The overall efficacy of Visteon combined with lithium carbonate is comparable to that of clozapine combined with lithium carbonate in the treatment of bipolar disorder, although the onset of effect is a little later, but the safety is high, and the patients are easy to accept. DISCUSSION: In the combined treatment of bipolar disorder, fluprednol combined with lithium carbonate or clozapine combined with lithium carbonate is the most common, although the efficacy is certain, but the side effects are obvious, the former is mostly with extrapyramidal side effects, and the latter is mostly with excessive sedation, anticholinergic, cardiovascular, hematopoietic system and other side effects, which is limited to a certain extent. In this study, the above side effects of clozapine combined with lithium carbonate did not affect the therapeutic efficacy although they were treated clinically. However, neurotoxicity and cardiovascular side effects also support the view that the two should be used together with caution. In recent years, Visteon alone or in combination with mood stabilizers for the treatment of mania has become a hot topic, tohen et al, found that Visteon combined with lithium carbonate and other mood stabilizers not only have good effects on mania, in this study, more than half of the patients in the end of the first week of treatment manic symptoms improved, the treatment of the sixth week, all the patients of the manic symptoms have been satisfactorily controlled. The overall efficacy of Visteon combined with lithium carbonate was similar to that of clozapine combined with lithium carbonate in the treatment of bipolar disorder in this study, with a slightly delayed onset of action in the Visteon group, but with less cardiovascular toxicity and fewer anticholinergic side-effects, and with better adherence to the treatment and a higher degree of safety for the patients. In addition to the antipsychotic effect of Visteon on D2,5-HT2, receptor, 5-HT2 is associated with antidepressant and anxiolytic effects, while the blockade of 5-HT1B is associated with sedative and antimanic effects. The present results show that Visteon combined with lithium carbonate for the treatment of mania has a similar efficacy to clozapine combined with lithium carbonate, but with fewer side effects, and is significantly better than the clozapine combined group treatment program, except for a slightly delayed onset of effect. The results suggest that lithium carbonate is superior to lithium carbonate in the treatment of mania, and Visteon can be one of the preferred drugs in the treatment of mania with psychotic symptoms and the need to combine antipsychotics.