PREDICTORS OF RESPONSE TO MOOD STABILIZERS

Although lithium remains the preferred treatment of bipolar disorder, only 60 to 80% of patients with tile classic presentation have an adeq uate response to this drug. When the response rate to lithium is consi dered across the entire spectrum of bipolar disorders, this rate proba bly decreases to 50%. Natural history, illness subtype, and comorbidit y are all important general predictors of response to treatment. At pr esent, the only predictors that seem to differentially favor divalproe x, and possible, carbamazepine over Lithium are :mixed states and rapi d cycling. An overview of clinical presentations that predict general and differential response to mood stabilizers is provided.