Antidepressant Activity of Mood Stabilizers

There is some evidence that the efficacy of antidepressant drugs in both unipolar and bipolar depression is decreasing and also for a possible usefulness of mood-stabilizing drugs in the pharmacotherapy of both these depressive states. In past two decades the number of drugs fulfilling the criteria for a mood stabilizer i.e. a drug which favourably influences mood abnormalities in bipolar disorder. has greatly increased. This article examines the utility of mood stabilizers, both classic (lithium, carbamazepine, valproate) and those of the second generation (atypical antipsychotics and lamotrigine) as antidepressants, in the treatment and prophylaxis of depression in bipolar and unipolar mood disorders. Clinical data show that lithium, quetiapine and lamotrigine are useful in the treatment and prophylaxis of bipolar depression and that they may have some therapeutic effects in the acute episode, as well as in the prophylaxis of unipolar depression. On the other hand, lithium, carbamazepine, atypical antipsychotics and lamotrigine have all been shown to augment antidepressants in treatment-resistant depression, both bipolar and unipolar.