[Are mood stabilizers beneficial in the treatment of schizophrenia?].
BACKGROUND
Antipsychotic agents are the drugs of choice in the treatment of schizophrenia. However, some patients profit only modestly from such therapy and thus represent a clinical challenge.


METHODS
This article is based upon a review of relevant literature on treatment with the mood stabilizers lithium, carbamazepine, valproate and lamotrigine in patients with schizophrenia.


RESULTS
Few well-designed studies exist on the use of mood stabilizers in schizophrenia. In monotherapy, these drugs have no documented beneficial effect, but when used as adjunct therapies to antipsychotics, some positive effects are described. Best evidence for an anti-aggressive effect exists for lithium, but it is described also for carbamazepine. Lithium also has some effects on affective symptoms. Valproate has not shown a consistently positive effect. Lamotrigine has demonstrated a beneficial effect in a placebo-controlled study, but this finding should be verified by others before its place in the treatment of schizophrenia can be established.


CONCLUSIONS
Mood stabilizers are not the drugs of choice in the treatment of schizophrenia but could be considered as potential adjuncts to antipsychotics in patients with treatment-resistant schizophrenia, although the documentation is sparse.
Berle
Jan Øystein
JØ
Fjell og Arstad DPS Avdeling Knappentunet, Helse Bergen HF, Haukeland Universitetssjukehus, 5021 Bergen og Regionsenter for barn og unges psykiske helse, Helseregion Vest Bergen. jan.berle@psyk.uib.no
Spigset
Olav
O
D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D008094:Lithium / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D002220:Carbamazepine; D014635:Valproic Acid; D008094:Lithium