Abstract
Background: Although treatment guidelines for bipolar disorder in many countries commonly include lithium carbonate joint with sodium valproate, this combination is not effective for all patients. Moreover, some adverse reactions related to this treatment, neurotoxicity and interaction with other drugs justify and call for a new reviewing of the issue. Methods: Evidence base for the interactions of combined drugs, the metabolic features, action mechanism, efficacy and side effects of these treatment combinations were reviewed. Considerable attention was given to the relationship of the mutual action of these drugs with their clinical efficacy but also their side effects. Results: The efficacy of combination therapy of lithium with valproate for treatment and prevention of mania were superior to monotherapy of lithium or valproate. Conclusion: Double mood stabilizer therapy is the best relative treatment for patients with bipolar disorder, especially mania and related episodes.
Highlights
The treatment of most manic, mixed and rapid cycling episodes involved a combination of mood stabilizers with antipsychotics
Treatment guidelines for bipolar disorder in many countries commonly include lithium carbonate joint with sodium valproate, this combination therapy has not been proven satisfactory for all patients
Evidence based medicine research was conducted to draw a conclusion on the efficacy of double mood stabilizers relative to one mood stabilizer in the treatment of bipolar disorder (Jin, 11)
Summary
The treatment of most manic, mixed and rapid cycling episodes involved a combination of mood stabilizers with antipsychotics. Treatment guidelines for bipolar disorder in many countries commonly include lithium carbonate joint with sodium valproate, this com-. Bination therapy has not been proven satisfactory for all patients. Such treatment combinations with their adverse reactions, neurotoxicity and interaction with other drugs justify and call for a new reviewing of the issue. The aims are to review the interactions of combined drugs, the metabolic features, action mechanism, curative as well as side effects of these treatment combinations. Considerable attention is given to the relationship of the mutual action of these drugs with their clinical efficacy and their side effects
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