[Are mood stabilizers beneficial in the treatment of schizophrenia?]

Antipsychotic agents are the drugs of choice in the treatment of schizophrenia. However, some patients profit only modestly from such therapy and thus represent a clinical challenge.

This article is based upon a review of relevant literature on treatment with the mood stabilizers lithium, carbamazepine, valproate and lamotrigine in patients with schizophrenia.

Few well-designed studies exist on the use of mood stabilizers in schizophrenia. In monotherapy, these drugs have no documented beneficial effect, but when used as adjunct therapies to antipsychotics, some positive effects are described. Best evidence for an anti-aggressive effect exists for lithium, but it is described also for carbamazepine. Lithium also has some effects on affective symptoms. Valproate has not shown a consistently positive effect. Lamotrigine has demonstrated a beneficial effect in a placebo-controlled study, but this finding should be verified by others before its place in the treatment of schizophrenia can be established.

Mood stabilizers are not the drugs of choice in the treatment of schizophrenia but could be considered as potential adjuncts to antipsychotics in patients with treatment-resistant schizophrenia, although the documentation is sparse.