1.1 historical management
Pharmacotherapy has long constituted the treatment of choice for bipolar disorder since lithium was discovered by the Australian psychiatrist J.F. Cade in 1949. In a recent review, it was concluded that lithium provides a prophylactic response for about two-thirds of patients with bipolar disorder only (Goodwin, 2002). Carbamazepine and Valproate appeared to prevent relapse as monotherapy even though there is still a paucity of data from randomized placebo-controlled trails (Keck &McEloy, 2002). Lamotrigine has been found to have a long-term role in delaying or preventing the recurrence of depressive episodes but lithium and dovalproex sodium remain the first line treatment (Calabrese, Shelton, Rapport, Kimmel, &Elhaj, 2002)