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Current Drug Therapy

Anticonvulsants for treatment of manic depression

Gustavo A. Delucchi, MD and Joseph R. Calabrese, MD
Cleveland Clinic Journal of Medicine November 1989, 56 (8) 756-761;
Donald G. Vidt
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Alan W. Bakst
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Gustavo A. Delucchi
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Joseph R. Calabrese
Department of Psychiatry, The Cleveland Clinic Foundation
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ABSTRACT

Although lithium remains the treatment of choice for manic depression, it is now well recognized that 20%-40% of patients either do not tolerate the drug or their disease does not respond to it. This subgroup of patients accounts for a substantial majority of the morbidity that accompanies this illness. For this reason, alternatives to lithium therapy will have a significant clinical impact. In a great majority of cases, the rapid-cycling variant of this disorder accounts for the resistance to lithium treatment. Recently, a growing body of literature has suggested that several medications routinely used in the management of seizure disorders, particularly carbamazepine and valproate, have therapeutic mood-altering properties. These drugs have been evaluated in numerous drug trials using open, double-blinded, longitudinal, and (in the case of carbamazepine) randomized designs. The authors comment on the phenomenology of manic depression and review the literature on use of anticonvulsants in the management of lithium-resistant manic depression.

INDEX TERMS
  • Anticonvulsants
  • Bipolar Disorder
  • Received April 1989.
  • Accepted July 1989.
  • Copyright © 1989 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 56 (8)
Cleveland Clinic Journal of Medicine
Vol. 56, Issue 8
1 Nov 1989
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Anticonvulsants for treatment of manic depression
Gustavo A. Delucchi, Joseph R. Calabrese
Cleveland Clinic Journal of Medicine Nov 1989, 56 (8) 756-761;

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Anticonvulsants for treatment of manic depression
Gustavo A. Delucchi, Joseph R. Calabrese
Cleveland Clinic Journal of Medicine Nov 1989, 56 (8) 756-761;
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  • Anticonvulsants
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