This meta-study sounds just like medicine and science. However, when one looks further into the studies and researchers themselves it becomes more complicated, and begins to look more like an art.
The recommendations for the management of acute mania remain mostly unchanged. Lithium, valproate and several atypical antipsychotics continue to be recommended as first-line treatments for acute mania. For the management of bipolar depression, new data support quetiapine monotherapy as a first-line option. Lithium and lamotrigine monotherapy, olanzapine plus selective serotonin reuptake inhibitors (SSRI), and lithium or divalproex plus SSRI/bupropion continue to remain the other first line options. First line options in the maintenance treatment of bipolar disorder continue to be lithium, lamotigine, valproate and olanzapine and fluoxetine as a second-line maintenance therapy for bipolar depression. New data also support quetiapine monotherapy as a second-line option for the management of acute bipolar II depression.
First of all, if one reads the fine print, this article was published by the pharmaceutical companies themselves. It is not an independent review. It is stated that "CANMAT has received unrestricted educational grant support from Janssen-Ortho, Eli Lilly & Co. and AstraZeneca." Wow, that's a great grant. It also goes over who has served on various boards and held consultancy positions for various pharmaceutical companies also including, GlaxoSmithKline, Novartis, Janssen, Bristo-Myers Squibb, Oryx, Pfizer, Janssen-Ortho, Lundbeck and Merrck Frosst, and continues to list more pharmaceutical companies and laboratories.
And then when one starts looking at the research and finds the pharmaceutical companies hiding the studies showing poor results and really bad side effects then one has to wonder, especially when published results barely show increases above placebo.
And then when the medical community wants to put a vitamin company out of business for not having sufficient results for the efficacy of their drug, who is actually doing the fighting?
My psychiatrist stated that bipolar disorder is 100% a chemical imbalance in the brain and requires treatment by mood stablizers. And although it has been shown that a variety of people are helped by these medications, it is by no means a cure-all for everyone. Although I may end up on lithium I believe I should be able to try other treatments first (I am not in a manic phase nor a danger to myself or others). So far the more I read about these medications the less impressed I am. I certainly don't want to gain 30-100 lbs, get rashes, forget things, be dizzy and disoriented, tremors...
So although there is tendency to believe all the guys in white coats and their research, there are a lot of questions surrounding mental health issues and treatments. Now I guess I had better start doing some research and find out what is going on.
Why not just add lithium to the water supply as suggested by Dr Howenstine, perhaps everyone should be forced to take it:
Placing lithium in the water supply would almost certainly lower crime rates and would also improve the productivity of many emotionally troubled persons.