tal., 1990). Another problem associated with the use oflithium is its use by pregnant women. Its use duringpregnancy has been associated with birth defects,particularly Ebstein's anomaly. Based on current data, therisk of a child with Ebstein's anomaly being born to amother who took lithium during her first trimester ofpregnancy is approximately 1 in 8,000, or 2.5 times that ofthe general population (Jacobson et al., 1992). There are other effective treatments for bipolardisorder that are used in cases where the patients cannottolerate lithium or can become unresponsive to it in thepast. The American Psychiatric Association's guidelinessuggest the next line of to be anticonvulsant such asvalproate and carbamazepine. These drugs are useful asantimanic agents, especially in those patients with mixedstates. Both of these medications can be used in combinationwith lithium or in combination with each other. Valproate isespecially helpful for patients who are lithiumnoncompliant, experience rapid-cycling, or have a problemwith alcohol or drug abuse. Neuroleptics such ashaloperidol or chlorpromazine have also been used to helpstabilize manic patients who are highly agitated orpsychotic. Use of these drugs is often necessary because theresponse to them are rapid, but there are risks involved intheir use. Because of the often severe side effects,benzodiazepines are often used in their place.Benzodiazepines can achieve the same results as Neurolepticsfor most patients in terms of rapid control of agitation andexcitement, without the severe side effects. In addition to the medical treatments mentioned forbipolar disorder, there are several other options availableto bipolar patients, most of which are used in conjunctionwith medicine. One such treatment is light therapy. Onestudy compared the response to light therapy of bipolarpatients with that of unipolar depresses patients. Patientsare free of psychotropic and hypnotic medications for atleast...
