Do the novel anticonvulsants have any adjunct value as mood stabilizers?
Yes. I think all those drugs have adjunct value. I think the key is in type. We might distinguish here between the more classic type I bipolar patients and the less classic type I bipolar patients. In the case of type I bipolar disorder, I think these other drugs should be restricted to adjunctive use, with gabapentin for adjunctive anxiety and perhaps insomnia; topiramate and zonisamide primarily for weight loss; and oxcarbazepine perhaps also in patients who have weight issues and who cannot take carbamazepine because of drug interaction issues.
