Review of double mood stabilizer treatments for bipolar disorder in China

Weidong Jin, Maria Uscinska, Yongchun Ma

Department of Psychiatry, Tongde Hospital Affiliated to Zhejiang Chinese Medicine University (Zhejiang Province Tongde Hospital, Zhejiang Province Mental Health Institute, Hangzhou, China.
Institute of Psychiatry, Kings College London, London, UK.

DOI: 10.4236/ojpsych.2014.41001                

Abstract

Background: Although treatment guidelines for bipolar disorder in many countries commonly include lithium carbonate joint with sodium valproate, this combination is not effective for all patients. Moreover, some adverse reactions related to this treatment, neurotoxicity and interaction with other drugs justify and call for a new reviewing of the issue. Methods: Evidence base for the interactions of combined drugs, the metabolic features, action mechanism, efficacy and side effects of these treatment combinations were reviewed. Considerable attention was given to the relationship of the mutual action of these drugs with their clinical efficacy but also their side effects. Results: The efficacy of combination therapy of lithium with valproate for treatment and prevention of mania were superior to monotherapy of lithium or valproate. Conclusion: Double mood stabilizer therapy is the best relative treatment for patients with bipolar disorder, especially mania and related episodes.

Keywords

Bipolar Disorde; Double Mood Stabilizers; Lithium Carbonate; Sodium Valproate

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Jin, W.D., Chen, J., Tang, X., Chen, Z., Zhang, J. and Tong, Z. (2007) Can two kinds of mood stabilizers share? Chinese psychiatric expert opinion surveys. Journal of Clinical Psychiatry, 17, 63-64. (in Chinese)
[2]	Jin, W.D., Chen, Z. and Chen, J. (2007) Advances in the pharmacology and combination application of lithium carbonate and sodium valproate. Chinese Journal of Psychiatry, 40, 120-122. (in Chinese)
[3]	Lu, W.M., Jin, W.D. and Wang, H., (2004) Double mood stabilizers for bipolar disorder: 3 case reports. Journal of Nervous Disorder and Mental Health, 4, 492. (in Chinese)
[4]	Hu, X. and Gao, C.G. (2006) A Comparative study of double mood stabilizers in treating manic symptoms. Practice Journal of Medicine and Pharmacology, 23, 778-780. (in Chinese)
[5]	Wu, Y., Lin, Y. and Li, Y. (2008) Control study of lithium carbonate combined with sodium valproate in the treatment of acute manic episodes. Journal of Clinical Psychology Medicine, 18, 51-52. (in Chinese)
[6]	Liu, S., Tian, B. and Qi, W. (2011) A comparative study of intravenous valproate and lithium in the treatment of acute mania. Journal of Psychiatry, 24, 22-24. (in Chinese)
[7]	Wang, H., Wang, N., Jin, W.D., Chen, J., Feng, B., Tong, Z. and Liu, L. (2008) Comparative study of combination of Sodium Valproate XR (Depakine) and Lithium Carbonate in the therapy for manic episodes. Journal of Nervous Disorder and Mental Health, 34, 98-100. (in Chinese)
[8]	Ma, Y.C., Ren, Z.B., Jin, W.D., Wang, H., Xing, B., Chen, J. and Wang, N. (2010) Comparative study of atypical antipsychotics combination with double mood stabilizers in the therapy for manic episodes. Shanghai Archives of Psychiatry, 22, 165-167. (in Chinese)
[9]	Liu, Y., Liu, W., Zhu, W. and Sun, L. (2007) A comparative study of lithium carbonate combined with sodium valproate in the prevention of bipolar disorder. Journal of Psychiatry, 20, 89-90.
[10]	Xu, W., Wang, X., Chen, C. and Li, Y. (2007) Efficacy and safety of combination therapy of valproate with lithium for recurrent mania. Chinese Journal of Psychiatry, 40, 86-89. (in Chinese)
[11]	Jin, W.D., Wang, H. and Wang, N. (2009) Meta-analysis of clinical efficacy of double mood stabilizers in treatment of bipolar disorder. Journal of Evidence-Based Medicine, 9, 168-171. (in Chinese)
[12]	Jin, W.D., Wang, H., Zhang, J., Ma, Y., Lu, W., Chen, J., Tong, Z. and Xing, B. (2007) Study of valproate effects on serum lithium levels in rats. Chinese Journal of Clinical Pharmacy, 16, 116-118. (in Chinese)
[13]	Jin, W.D., Ma, Y., Ren, Z., Wang, H., Xing, B. and Tong, Z. (2011) Mutual influence of drug concentration in serum between lithium carbonate and sodium valproate: A preliminary study. Chinese Journal of Psychiatry, in Press. (in Chinese)