Maintenance treatments for bipolar disorders

Abstract

Bipolar disorders are disabling and, for most patients, recurrent illnesses. lithium is the 'gold standard' mood stabiliser in terms of efficacy, but many patients find it difficult to tolerate. The anticonvulsants sodium valproate and carbamazepine are useful despite minimal controlled evidence for their prophylactic efficacy. The approval of olanzapine and lamotrigine for maintenance treatment increases the choice of drug therapy. These new drugs, in conjunction with the development of effective psychological interventions, mean that the clinician has an increasing range of effective options to offer patients with these disabling and challenging conditions.