ABSTRACT
Monotherapy for bipolar disorder is well established as both acute and prophylactic treatment, the most familiar drugs used in these roles being lithium, sodium valproate, and carbamazepine (1-3). The choice of agent can be guided at least in part by the subtype of bipolar disorder, for instance, valproate possibly being more efficacious in rapid cycling illness than lithium (3-6). More recently, a literature is beginning to accumulate regarding the efficacy of other anticonvulsant drugs (1,4,7-14)— although gabapentin does not have evidence to support this action (15,16)—and also antipsychotic medication, particularly atypical antipsychotic drugs (17-20). Indeed, formal recognition of the value of such alternative agents in the treatment of bipolar disorder is now reaching the level at which, at least in the case of atypical antipsychotics, licenses are beginning to be granted to them specifically for this purpose.
