Lithium

Lithium is commonly known as the first mood stabilizer. Although it was discovered in 1817, it was not until much later in the century that it was found to have mood stabilizing properties, specifically anti-manic capabilities. By 1969 it was the preferred method of treating manic depression.

It is not known exactly how lithium works with the brain to stabilize moods. It's theorized that those afflicted with bipolar disease have a chemical imbalance in the part of the brain that controls emotions and that lithium helps to restore the correct balance.

Today, lithium is usually the first drug treatment attempted when treating bipolar disorder. It is especially effective if there is a family history of bipolar disorder. If a family history does not exist, Lithium tends to be less effective and other treatments may be attempted instead.

Recently, because of its toxicity and other negative effects, some medical professionals have begun to shy away from prescribing lithium.

Valproate

In the United States, valproate is the second most popular drug used to fight bipolar disorder. This seems to be mainly a direct result of the many lithium side effects and concerns. Even among doctors that prefer lithium as a first choice, valproate is usually a strong second choice. Also, as mentioned above, lithium is not always effective for treating bipolar disorder. In these cases, valproate is often considered a good alternative treatment.

Although lithium and valproate appear to have similar efficacy in treating bipolar disorder, there have been no head to head clinical trials between the two so a definitive conclusion cannot be reached. However, because valproate is less stressful to the human body, this may be a natural drug preference for some.

A second concern with using valproate is that while it has been proven to be effective against bipolar mania, it has been less effective against bipolar depression.

Carbamazepine

In Europe, carbamazepine, introduced in the early 1960s, is the second most popular drug used for treating bipolar disorder. Although, studies have proven it to be effective for bipolar disorder, it has not been approved worldwide.

And as with the drug valproate, carbamazepine while effective for treating bipolar mania, has also been less effective at treating bipolar depression.

Conclusion

Of the top three drugs used to fight bipolar disease, they all seem to be relatively equal in treating bipolar mania. However, when it comes to treating bipolar depression and in reducing feelings of suicide, lithium appears to have the clear edge.

Unfortunately, many of the studies that current bipolar treatment is based on are 15 or more years old and are very much out of date.

Fortunately, the scientific community, recognizing this, is becoming more interested in studying new treatments for bipolar mania. There are many medical trials underway that will test the potential for a new class of bipolar drugs and hopefully lead to much needed help for families dealing with this emotional wrenching disease.