Clinical Pharmacodynamics and Pharmacokinetics of Antimanic and Mood-Stabilizing Medications

Background: A number of medications are now available or are in development as antimanic and/or moodstabilizing agents. We reviewed the clinical pharmacodynamics and pharmacokinetics of these agents to provide a summary of these properties relevant to clinical practice. Method: We conducted a MEDLINE search augmented by a manual search of bibliographies and a review of textbooks to identify articles regarding the clinical pharmacology of lithium, valproate, carbamazepine, oxcarbazepine, olanzapine, clozapine, risperidone, ziprasidone, quetiapine, lamotrigine, and topiramate. Results: Not surprisingly, there are a number of clinically relevant pharmacodynamic and pharmacokinetic differences among these medications, and these differences are discussed. Conclusion: Knowledgeof the clinical pharmacology of established and putative antimanic and mood-stabilizing medications is important inadministering these agents safely and effectively.