Lithium: the present and the future.

In summary, Dr. Keck reported that the literature as a whole shows lithium, valproate, and carbamazepine to be about comparable in treating acute mania. Lithium appears to be clearly efficacious for the treatment of acute bipolar depression; valproate has shown equivocal results, and carbamazepine weakly positive results, when used to treat this condition. Results of controlled studies show that maintenance therapy with lithium is effective in preventing recurrence of manic depressive illness; results of valproate for maintenance therapy are pending; and carbamazepine therapy can be effective but less so compared to lithium.