Predictors of response for mood stabilizers in bipolar affective disorders

Since the introduction of lithium ions in the acute treatment and in the pr ophylaxis of bipolar disorders the antiepileptic drugs valproate and carbam azepine have been in use for several years as mood stabilizers. In a number of open and controlled clinical studies predictors of response for the sin gle drugs were investigated. These studies indicated that valproate was a p redictor of good response in mixed (dysphoric) mania and bipolar rapid cycl ing. Moreover, valproate has a better response than lithium in secondary ma nia (organic origin) and atypical mania (episode sequence: depression - man ia - euthymia rather than mania - depression - euthymia). The preferential efficacy in the spectrum of bipolar disorders of the new antiepileptic drug s lamotrigine and gabapentin must be analysed in more detail in future stud ies.