ABSTRACT
Comprehensive management of bipolar disorder requires treatment of acute mania and depression, as well as the prevention of mania and depression during the maintenance phase. The most stringent definition of a mood stabilizer would require efficacy in all phases; however, these conditions are not easily met. A review undertaken by Bauer and Mitchner designed to evaluate how well specific agents met more or less stringent definitions of mood stabilizer concluded that only lithium, which has some degree of efficacy in all phases, is a true mood stabilizer based on the most restrictive definition1. Despite the fact that there is more evidence available on the use of lithium than any other drug in maintenance treatment of bipolar disorder2, there has been a fairly marked shift away from the prescription of lithium in the USA compared to Europe and the rest of the world.
