PT  - JOURNAL ARTICLE
ED  - Vidt, Donald G.
ED  - Bakst, Alan W.
AU  - Gustavo A. Delucchi
AU  - Joseph R. Calabrese
TI  - Anticonvulsants for treatment of manic depression
DP  - 1989 Nov 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 756--761
VI  - 56
IP  - 8
4099  - http://www.ccjm.org/content/56/8/756.short
4100  - http://www.ccjm.org/content/56/8/756.full
SO  - Cleve Clin J Med1989 Nov 01; 56
AB  - 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.