Carbamazepine: A Possible Alternative in Lithium-Resistant Bipolar Disorder

The prophylactic effect against new affective episodes is the most well-established effect of lithium1,2. However not all patients with recurrent affective episodes benefit from lithium. Kukopulos et al.3,4 found that 60 of 213 bipolar patients (28%) did not respond. Especially “rapid cycling” patients tended to show a poor response, as has also been reported by Dunner and Fieve5 and by Petursson6.