title: Clinical inquiries: what drugs are best for bipolar depression?
abstract: Antidepressants and lamotrigine are effective. Atypical antipsychotics, lithium, and anticonvulsants also may help. Antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs), are useful adjuncts in short-term treatment of bipolar depression and have low rates of inducing mania (strength of recommendation [SOR]: 1 systematic review and randomized controlled trials [RCTs]). Lamotrigine is beneficial for both acute treatment of bipolar depression and prevention of recurrent episodes (SOR: 1 systematic review and 1 RCT). Some atypical antipsychotics alone (SOR: 2 RCTs) or in combination with antidepressants (SOR: 1 multicenter RCT) effectively treat acute bipolar depression. Lithium and anticonvulsants such as valproate also may be useful (SOR: limited number of studies with small sample sizes).
authors.affiliation: Department of Family Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Chibuzo
authors.initials: C
authors.lastname: Ukaegbu
authors.forename: J Burton
authors.initials: JB
authors.lastname: Banks
authors.forename: Nakia J
authors.initials: NJ
authors.lastname: Carter
authors.forename: Larry S
authors.initials: LS
authors.lastname: Goldman
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D006801:Humans; D000077213:Lamotrigine; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D014227:Triazines; D000077213:Lamotrigine