Drug of choice for rapid cyclers in manic-depressive psychosis is:
uction in manic relapses is noted when valproate is used in bipolar disorder. It is now a first line treatment of acute mania in which high dose valproate acts faster and is an alternative to antipsychotic +- benzodiazepine. It can be useful in those not responding to lithium or not tolerating it. Patients with rapid cycling pattern may paicularly benefit from valproate therapy Ref: KD Tripati 8th ed.
Carbamazepine
Valproate
Phenytoin
Lithium
Central Nervous system