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British Medical Bulletin 57:179-192 (2001)
© 2001 Oxford University Press

Developments in mood stabilisers

Depression and public health

I Nicol Ferrier

Department of Psychiatry, University of Newcastle upon Tyne, Newcastle upon Tyne, UK

Bipolar affective disorder is a life-long condition with profound effects on sufferers' social and occupational life. Despite efficacy in clinical trials and in some groups of patients, lithium's effectiveness in clinical practice is hampered by its side effect profile and limited concordance. Alternative and adjunctive treatments to lithium in bipolar disorder have been sought and the anticonvulsants carbamazepine and valproate show promise. Despite these advances, treatment resistance persists. Lamotrigine, a new anticonvulsant, is increasingly used in treatment-resistant cases under specialist supervision. Further pharmacological and non-pharmacological strategies for bipolar prophylaxis are currently under investigation. These developments are the focus of this review.


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