Anticonvulsants for Mental Disorders: Valproate, Lamotrigine, Carbamazepine and Oxcarbazepine

Several anticonvulsants are licensed and used in the treatment of bipolar disorder. However, anticonvulsant activity does not automatically confer benefits for mood disorders on a drug. The anticonvulsant drugs with the strongest evidence for effectiveness in bipolar disorder are valproate, lamotrigine and carbamazepine. Furthermore, the relative effectiveness of these drugs for the different phases of bipolar illness (mania or depression, and acute or maintenance treatment) differs, and none of them has a pattern of effectiveness across the three phases equivalent to lithium. This chapter will describe the basic and clinical psychopharmacology for each of these drugs in turn, as it relates to their use and effectiveness in mental disorders.