VALPROATE IN BIPOLAR DISORDER - THE CANADIAN PERSPECTIVE

Lithium is the primary treatment for bipolar disorder. However, a subs tantial proportion of patients are either lithium-resistant or develop side-effects which limit the effectiveness of treatment. The anticonv ulsants, particularly valproate and carbamazepine, are alternatives to lithium in the treatment of bipolar disorder. The data on the efficac y of these compounds are reviewed. Clinical issues relating to their u se as an alternative to lithium and potentially as a first-line treatm ent are discussed. The role of anticonvulsants in the broad range of t reatment options available for bipolar patients are evaluated.