An analysis of the efficacy of treatments for bipolar depression.
Individuals with bipolar disorder are euthymic approximately half of the time, but recurring mood episodes are common, and time spent ill is predominated by depressive symptoms. Despite the prevalence of depression in bipolar disorder, evidence suggests that antidepressants are not likely to benefit most patients. Lithium, long considered a first-line treatment for bipolar disorder, is not the most effective agent for preventing bipolar depression. This article reviews multiple pharmacologic options that should be considered by clinicians treating bipolar disorder in both acute and maintenance phases.
Nierenberg
Andrew A
AA
Department of Psychiatry, Harvard Medical School and Depression Clinical and Research Program and Bipolar Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. anierenberg@partners.org
D000208:Acute Disease; D016907:Adverse Drug Reaction Reporting Systems; D000339:Affect / Q000187:drug effects; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003937:Diagnosis, Differential; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000627:therapeutic use; D008134:Long-Term Care; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D005473:Fluoxetine; D001569:Benzodiazepines; D016651:Lithium Carbonate; D000069348:Quetiapine Fumarate; D000077152:Olanzapine