Bipolar affective disorders are psychic diseases with a life time prevalence of at least 1.5 %. The life time prevalence increases up to 5 - 6 % when the spectrum of bipolar disorders is taken into account (Angst 1995). Although bipolar disorders are frequently occurring disorders the diagnosis and the therapy of bipolar affective disorders in Germany are not so soffisticated as in the United States. In the last years a detailed psychopathological differentiation of patients with bipolar disorders was initiated. One differentiation is the group of bipolar I- versus bipolar II-patients, rapid cycling with at least four episodes of the disease (up to 20 % of the patients) and the dysphoric and mixed mania (up to 40 % of the patients).

In the treatment of different formes of manic depressive diseases studies have shown that antiepileptic drugs as mood stabilizers play a major role. Especially valproate has been shown in some clinical investigations to be very efficacious in rapid cycling and mixed mania.

In this context Dr. M. Dobmeier, Regensburg, will give an overview of the results of the so called AMÜP-study in Bavaria indicating the administration of neuroleptics and mood stabilizers in bipolar disorders.

Another problem in the treatment of bipolar disorders is the treatment of bipolar depression. In this context there are some hints in the literature that some antidepressive drugs might induce a switch into mania. Dr. R. Bottländer, Munich, will give a talk about the efficacy and the switch-risk of antidepressives in bipolar depression.

The use of of the antiepileptics valproate and carbamazepine as mood stabilizers are sometimes complicated with a comedication with neuroleptics and antidepressive drugs. Dr. C. Normann, Freiburg, will present a study showing interactions between neuroleptics and the antiepileptics valproate and carbamazepine.

Besides the old epileptic drugs valproate and carbamazepine as mood stabilizers the new antiepileptic drugs lamotrigine and gabapentin might have its place in the treatment of bipolar disorders. Dr. A. Erfurth, Münster, will present data of the use of these two new antiepileptic drugs in the treatment of bipolar disorders.

The last presentation will be from Prof. Greil and Dr. Kleindienst (Kilchberg / München) showing the prophylactic efficacy of mood stabilizers in typic versus atypical manifestations of bipolar disorders. In this context the authors will represent data of a study comparing lithium and carbamazepine in the prophylaxis of bipolar affective disorders.