Mood stabilizers: lithium and anticonvulsants

Abstract

Abstract In the process of studying the toxicity of uric acid from patients with manic–depressive illness in guinea pigs, the Australian physician John Cade noted in 1949 that animals became lethargic after injection with lithium carbonate, a monovalent cation (Cade, 1978). This led to the administration of lithium citrate to a manic adult patient who had a marked clinical improvement (Cade, 1978). Twenty years later, lithium was approved by the Federal Drug Administration (FDA) for the treatment of mania in adults. Since then, it has traditionally been used as the preferred treatment of mania in adults (Post et al., 1997) and adolescents (Strober et al., 1990) with bipolar disorder (BD). One double-blind, placebocontrolled study of adolescent mania showing a 43% response efficacy (Geller et al., 1998a) suggests that adolescents with BD may have a similar or even lower response efficacy to lithium compared with adults.