Mood-stabilizing drugs in depression

Mood-stabilizing drugs including lithium, anticonvulsants, and antipsychoti cs have established effects in the management of bipolar disorder, especial ly in mania. However, these drugs also have been shown to be effective in d epressed patients. For example, lithium is well established as an effective augmenting strategy with tricyclic antidepressants in refractory depressio n. This article will review a variety of effects of mood-stabilizing drugs in bipolar and unipolar depressed patients, which will include acute treatm ent, prevention of relapse and recurrence, and the management of refractory patients. The effects of antipsychotics (especially atypicals) and new res earch directions also will be reviewed.