Why has valproic acid become the most commonly used mood stabilizer? Review article
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Abstract
Paradoxically, as evidence about the therapeutic efficacy of lithium increases there is a relative decrease in lithium prescribing in most of developed countries. Actually, lithium use overall remained constant, whilst second generation antipsychotics, combinations and especially valproate use has increased dramatically from the beginning of nineties in 20th century in bipolar treatment. The various reasons for the decreasing lithium and rise of valproate trends play a role in prescribing practice. The lithium unfavorable side effect profile, its problems with patients’ adherence and on the other hand the more clinically universal profile of valproate, effective in various forms bipolar disorders, both during monotherapy or in combinations, can explain all these trends. New reports on the unique neurotrophic potential of valproate are probably also taken into account by psychiatrists.
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