DIFFERENTIAL TREATMENT OF BIPOLAR DISORDER WITH OLD AND NEW ANTIEPILEPTIC DRUGS

Although lithium remains the preferred medication for bipolar disorder s, new investigations suggest that only 60 to 80% of patients have a g ood response with a classical presentation. The antiepileptics carbama zepine and valproate are important alternatives. Several studies have shown that lithium, carbamazepine and valproate are effective in pure mania. Mixed mania and rapid cycling respond, however, well to valproa te. One disadvantage of carbamazepine is its enzyme inducing property with the consequence of a decrease of plasma levels of other psychotro pic medications and a worsening of psychopathology. First data indicat e a good antimanic and antidepressive efficacy of the new antiepilepti c drug lamotrigine.