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Pharmacological approaches in bipolar disorders and the impact on cognition: a critical overview.<\/jats:p><jats:p><jats:bold>Objective:\u2002<\/jats:bold> Historically, pharmacological treatments for bipolar disorders (BD) have been associated with neurocognitive side\u2010effects. We reviewed studies which assessed the impact of several psychopharmacological drugs on the neurocognitive function of BD patients.<\/jats:p><jats:p><jats:bold>Method:\u2002<\/jats:bold> The PubMed database was searched for studies published between January 1980 and February 2011, using the following terms: bipolar, bipolar disorder, mania, manic episode, or bipolar depression, cross\u2010referenced with cognitive, neurocognitive, or neuropsychological, cross\u2010referenced with treatment.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Despite methodological flaws in the older studies and insufficient research concerning the newer agents, some consistent findings emerged from the review; lithium appears to have definite, yet subtle, negative effects on psychomotor speed and verbal memory. Among the newer anticonvulsants, lamotrigine appears to have a better cognitive profile than carbamazepine, valproate, topiramate, and zonisamide. More long\u2010term studies are needed to better understand the impact of atypical antipsychotics on BD patients\u2019 neurocognitive functioning, both in monotherapy and in association with other drugs. Other agents, like antidepressants and cognitive enhancers, have not been adequately studied in BD so far.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Pharmacotherapies for BD should be chosen to minimize neurocognitive side\u2010effects, which may already be compromised by the disease process itself. Neurocognitive evaluation should be considered in BD patients to better evaluate treatment impact on neurocognition. A comprehensive neuropsychological evaluation also addressing potential variables and key aspects such as more severe cognitive deficits, comorbidities, differential diagnosis, and evaluation of multiple cognitive domains in longitudinal follow\u2010up studies are warranted.<\/jats:p>","DOI":"10.1111\/j.1600-0447.2012.01910.x","type":"journal-article","created":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T05:47:47Z","timestamp":1344577667000},"page":"315-331","source":"Crossref","is-referenced-by-count":128,"title":["Pharmacological approaches in bipolar disorders and the impact on cognition: a critical overview"],"prefix":"10.1111","volume":"126","author":[{"given":"V. V.","family":"Dias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Balanz\u00e1\u2010Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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