1. Other drugs used in the treatment of bipolar disorder
Domina Petric, MD

2. Katzung, Masters, Trevor. Basic and clinical pharmacology.
Valproic acid
Valproic acid (valproate) is antiepileptic.
It has been demonstrated to have antimanic effects.
Valproate shows efficacy equivalent to that of lithium during the early weeks of treatment.
Valproate has been effective in some patients who have failed to respond to lithium.
The starting dose is 750 mg/day, increasing rapidly to the mg range.
Recommended maximum dosage is 60 mg/kg/day.
Dose increase may cause nausea.
Katzung, Masters, Trevor. Basic and clinical pharmacology.

3. Katzung, Masters, Trevor. Basic and clinical pharmacology.
Carbamazepine
Carbamazepine has been considered to be a reasonable alternative to lithium when the latter is less than optimally efficacious. Carbamazepine may be used to treat acute mania and for prophylactic therapy. It may be used alone or in combination with lithium, or, rarely, valproate, in the cases of refractory bipolar disorder. Dosage usually begins with 200 mg twice daily, with increases as needed. Maintenance dosage is mg/day.
Katzung, Masters, Trevor. Basic and clinical pharmacology.

4. Katzung, Masters, Trevor. Basic and clinical pharmacology.
Carbamazepine
Plasma concentrations between 3 and 14 mg/L are considered desirable.
Overdose of carbamazepine is a major emergency and should generally be managed like overdoses of tricyclic antidepressants.
Katzung, Masters, Trevor. Basic and clinical pharmacology.

5. Katzung, Masters, Trevor. Basic and clinical pharmacology.
Lamotrigine
Lamotrigine may be useful in preventing the depression that often follows the manic phase of bipolar disorder.
Katzung, Masters, Trevor. Basic and clinical pharmacology.

6. Katzung, Masters, Trevor. Basic and clinical pharmacology.
Literature
Katzung, Masters, Trevor. Basic and clinical pharmacology.