Am J Psychiatry 1989; 146:840-848
Copyright © 1989 by American Psychiatric Association
Alternatives to lithium for preventive treatment of bipolar disorder
RF Prien and AJ Gelenberg
Affective and Anxiety Disorders Research Branch, Division of Clinical Research, NIMH, Rockville, MD 20857.
The authors review the research literature on drug treatment for the
prevention of recurrences in bipolar disorder, emphasizing the available
alternatives to lithium therapy. They discuss the need for alternative
treatments and the current status of promising agents. Carbamazepine
receives special attention because of its status as the most promising
backup treatment for lithium. The authors conclude that despite the
extensive literature on carbamazepine, there is strong need for carefully
designed, prospective, double-blind studies to establish the efficacy of
carbamazepine alone and in combination with lithium as a prophylactic
treatment for bipolar disorder. Difficulties in developing and evaluating
preventive maintenance are discussed.
