[Current trends in the therapeutic use of thymic regulators]

LITHIUM: Current research in the field of dysthymia therapy is dominated by the discovery of alternatives to lithium. Lithium remains however the gold standard, whether used alone or combination with anti-seizure drugs such as carbamazepine, valpromide or valproate. The most recent data on lithium therapy emphasize the need for precaution in case of pregnancy. New interactions, particularly with converting enzyme inhibitors, have also been evidenced. Finally, like beta blockers, lithium should be tapered off progressively over a two-month period to avoid early relapse. OTHER TREATMENTS: New candidate drugs such as lamotrigine offer some promising perspectives. For severe states, long-term electroconvulsivotherapy can be proposed. Finally, drug therapy should be integrated into a structured psychotherapy program in order to favor the prevention of relapse and reduce the negative psychosocial consequences of mood disorders. Both the patient and close family and friends should participate in the psychotherapy; several methods have been developed with promising efficacy to be confirmed by controlled studies.