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Alternative treatment strategies for lithium in bipolar disorder

Published online by Cambridge University Press:  18 September 2015

P.F. Bouvy
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Summary

Indications for lithium in the treatment of bipolar disorders are acute mania, depression and preventive treatment. In the case of insufficient efficacy or adverse effects the first alternative for lithium in acute mania is carbamazepine. However, the role of carbamazepine in preventive treatment is still uncertain. Well designed prospective research is hardly done. Clearly positive reports on the efficacy of carbamazepine concern specific lithium-resistant groups such as the ‘rapid-cyclers’. Valproic acid has been found effective in a few studies in bipolar disorders, especially in acute mania. Clonazepam is sometimes mentioned as a possible alternative, however recent research seriously questions the efficacy of clonazepam in bipolar disorders. Calcium-antagonists, especially verapamil, may have some efficacy in the treatment of acute mania, their role is still very uncertain.

Keywords

bipolar disordercarbamazepinevalproic acidclonazepamverapamilbipolaire stoorniscarbamazepinevalproinezuurclonazepamVerapamil
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 5 , Issue 3 , September 1993 , pp. 55 - 59
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1993

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