Bipolar Disorders and the Effectiveness of Novel Anticonvulsants

The discovery that valproic acid is helpful in the management of patients with rapid-cyclingbipolar disorder led to an explosion of research culminating in the third-generation anticonvulsants.Refractory depressive phases are frequent in bipolar disorders. No studies to date have shown thatgabapentin is effective in bipolar mania or hypomania. Lamotrigine may have a role in treating bipolardepressive episodes, but it is not a particularly effective antimanic agent. Topiramate has shownencouraging results in both depressed and manic bipolar patients, and it may also promote weightloss. The new anticonvulsants are promising agents for the treatment of bipolar disorders, but they areheterogeneous with regard to their efficacy, target symptoms, and adverse event profiles.