[Predictors of response to phase prophylactics (mood stabilizers) in bipolar affective disorders]

Since the introduction of lithium ions in the acute treatment and in the prophylaxis of bipolar disorders the antiepileptic drugs valproate and carbamazepine have been in use for several years as mood stabilizers. In a number of open and controlled clinical studies predictors of response for the single drugs were investigated. These studies indicated that valproate was a predictor of good response in mixed (dysphoric) mania and bipolar rapid cycling. Moreover, valproate has a better response than lithium in secondary mania (organic origin) and atypical mania (episode sequence: depression-mania-euthymia rather than mania-depression-euthymia). The preferential efficacy in the spectrum of bipolar disorders of the new antiepileptic drugs lamotrigine and gabapentin must be analysed in more detail in future studies.