New antiepileptic drugs (AED) and atypical antipsychotics (AAP) as mood stabilizers

Over the last two years many perspectives of bipolar disorders (BD) have been studied in order to find more effective drugs with a better tolerability. Rapid cycling, ultra rapid cycling, BD II, gender differences and treatment of acute affective states as well as relapse prevention have been addressed. Because of their better benefit- to-risk ratio atypical antipsychotics (AAP) have gained much interest in BD also due to their well known dosing regimens according to the treatment in schizophrenia. Besides already published data, new still ongoing trials with AED and AAP will be presented and discussed. The AED that seems to be very promising in BD perhaps even as a monotherapy is lamotrigine (besides valproic acid, carbamazepine and oxcarbazepine), other newer ones possibly as add-on medication. AAP investigated for the treatment of BD are amisulpride, aripiprazol, olanzapine (1), quetiapine, risperidone (2) and ziprasidone. In this context, it has to be taken into consideration what affective state they are most effective for, what length of time they have been studied as mood stabilizers and furthermore, what kind of side effects could be expected (i.e. weight gain, EPS, PCO-syndrome, erythema).

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