Novel alternatives and supplements to lithium and anticonvulsants for bipolar affective disorder.
BACKGROUND
Most clinicians are familiar with the traditional anticonvulsants as alternatives to lithium in the treatment of bipolar mood disorders.


METHODS
This review of the English, French, German, and Italian language literature on novel treatments, including electroconvulsive therapy, calcium channel blocking agents, antipsychotic drugs, benzodiazepines, thyroid hormone, psychosurgery, and two new antiepileptic drugs, that have not been studied as extensively as lithium, carbamazepine, and valproate but that may have promise as alternatives or supplements to traditional thymoleptics when the standard treatments are not effective or are poorly tolerated. We searched MEDLINE and PSYCHINFO data bases using the keywords bipolar, mood, and/or treatment. We then searched bibliographies of articles retrieved by the first strategy.


RESULTS
The theoretical rationale for each treatment is discussed, followed by a critical discussion of the evidence supporting its efficacy.


CONCLUSIONS
The potential risks and benefits of each treatment in actual clinical practice are placed in perspective.
Dubovsky
S L
SL
Department of Psychiatry, University of Colorado School of Medicine, Denver 80262, USA.
Buzan
R D
RD
D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004565:Electroconvulsive Therapy; D006801:Humans; D011612:Psychosurgery; D013963:Thyroid Hormones / Q000627:therapeutic use; D013974:Thyroxine / Q000627:therapeutic use
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D002121:Calcium Channel Blockers; D013963:Thyroid Hormones; D001569:Benzodiazepines; D013974:Thyroxine