The field of bipolar affective disorders research now immence methodological challenges, some of which have only recently become obvious.

It has become more clear that bipolar affective disorder should be viewed longitudinally rather than in terms of individual episodes. As result of these methodological challenges, more have been far a few mood stabilizers approwed for use in bipolar disorder. Lithium was the gold standard of treatment for bipolar disorder, but a number of studies over the past several decades shown that many drugs with antiepileptic properties are effective in the treatment of some patients with bipolar affective disorder, especially for those whose disorder inadequately responds to lithium, and those who are intolerant of treatment with lithium. These antiepileptic agents include two generations of drugs: cabamazepin and valproate as first generation, and lamotrigine, gabapentine and topiramate as second generation of mood stabilising antiepileptic agents. In this article are rewiew the pharmacological properties and their efficacy in the treatment of bipolar disorder.

A series of 32 patients with bipolar affective disorder was reported. All patients were supervized in the Emergency psychiatry service in Psychiatric Hospital Skopje, as the greatest and most important psychiatric institution in Macedonia. We also summarise use of these agents in combination with other psychotropics.