Abstract

MONCRIEFF, Joanna. Lithium and other drugs for manic-depressive and bipolar disorder. Rev. Asoc. Esp. Neuropsiq. [online]. 2018, vol.38, n.133, pp.283-299. ISSN 2340-2733.  https://dx.doi.org/10.4321/s0211-57352018000100015.

Manic-depressive disorder, as it was understood in the past, is a rare condition. However, the evolution of the concept has generated the bipolar construct. This concept includes several conditions, of diffuse limits, which can be frequently found. Disorders of the so-called “bipolar spectrum” have nowadays a high prevalence in adults. Drugs known as “mood stabilizers” are supposed to decrease the affective alterations of bipolar disorder. However, there is no evidence of this supposed stabilizer action on mood swings. The main object of this paper is to look through the scientific bases of pharmacological treatments for bipolar disorder. Only type I bipolar disorder counts on a body of research on pharmacological interventions in acute situations, as well as on maintenance treatments that claim to prevent relapses and recurrences. There is no strong evidence for the superiority of lithium over the rest of sedative drugs, or for its specific action on treating type I bipolar manifestations. In the rest of conditions of the bipolar spectrum, research studies are limited. In addition, in this paper, evidence underlying the current belief about anti-suicidal properties of lithium is considered, resulting to be very weak. Clinicians are encouraged to inform the individuals diagnosed with bipolar disorder about the scientific evidence regarding benefits and risks of medication, so that they can make decisions about the strategy to follow in case of a new crisis, maintaining, or not, a pharmacological long-term treatment or implementing other strategies.

Keywords : bipolar disorder; bipolar spectrum; mood stabilisers; lithium; suicide.

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