[Treatment of a first depressive episode in bipolar disorder].
The first episode of bipolar depression needs a combined psychopharmacological, psychobehavioural and social treatment strategy but because of the pathological severity of the mood episode itself, it specifically requires to achieve total symptomatic remission and therefore appropriate treatment of the index episode. International recommendations which derive primarily from Anglo-Saxon regulations formally restrict the use of antidepressants in view of the risk of mania, suggesting that serotoninergic agents be used in preference and recommending the prescription of mood regulators or even antipsychotic agents and various stepwise associations based on the relative potencies of the pharmacological tools available and treatment stages deployed optimally to obtain complete remission. Finally, treatment of the episode includes prophylaxis as its initial episode is the first presentation of a chronic disease.
Pringuey
D
D
Clinique de Psychiatrie et de Psychologie Médicale Abbaye de Saint Pons, Pôle des Neurosciences Cliniques, CHU Pasteur Nice. pringuey.d@chu-nice.fr
Cherikh
F
F
Tible
O
O
Giordana
B
B
D000339:Affect / Q000187:drug effects*; D000465:Algorithms; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D003131:Combined Modality Therapy; D003863:Depression / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011613:Psychotherapy; D055502:Secondary Prevention; D017366:Serotonin Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*
D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D017366:Serotonin Receptor Agonists