[Prediction of the efficacy of thymoregulators]

Among clinical factors, the compliance amounts to 47 to 82% of the patients. Recent data contradict the classical poor response of unipolar patients to lithium. Most studies realized on bipolar patients concern bipolars type I. Bipolar patients type II often show comorbidity factors which predict poor response to lithium or carbamazepine. The clarity of mood disorders and the frequency of cyclers have a bearing on the treatment response. But hypothyroidisms described in rapid cyclers do not predict response to L. thyroxine. We should also take into account the sequence of episodes and the type of index episode. The data concerning other possible mood stabilizers are scarce. Among biological parameters, the results are very upsetting. The calcium levels, serotonin levels, the red blood cell/plasma lithium ratio essentially predict tolerance or compliance. The various psychological tests do not enable us to identify a sub-group of patients responding to lithium. The remaining difficulties in the predictive capacity enhance the importance of establishing for each patient the precise history of the illness and previous treatments.