Lithium salts were first reported to be effective in the treatment of Mania by Cade in 1949. Lithium is effective both as an antimanic and as a mood-stabilizing agent.
The use of Lithium as an antimanic agent often requires doses higher than those required for maintenance treatment. Cade's rapid titration has been recently found to be effective in controlling manic symptoms among inpatients with Mania.
The efficacy Lithium as a maintenance treatment in all forms of MDI has been demonstrated by reduced rates of hospitalization, decrease in frequency and severity of symptoms, improved psychosocial functioning, decreased rate of suicide, and worsening of course of illness after treatment discontinuation.
Anticonvulsants, like Carbamazepine and Valproic Acid and Valproate have been studied and used as antimanic and mood stabilizing agents since the late '70's and early '80's. More recently other anticonvulsants have been used in combination with other treatments for MDI.
Valproic Acid and Sodium Divalproex have been studied as maintenance treatment for patients with Bipolar disorder, and found to be more effective than Lithium in mixed manic states and in some rapid cycling forms of MDI.
The Pharmacological Treatment of Pediatric BD