title: Bipolar depression: overview and commentary.
abstract: Depressive phases are the most prevalent component of bipolar disorders, even with modern treatment. Bipolar depressive morbidity is often misdiagnosed and is limited in response to available treatments. These conditions are especially debilitating and are associated with psychiatric comorbidity, substance abuse, functional disability, and increased mortality owing to early suicide and accidents, and later medical illnesses. There is growing awareness that bipolar depression is one of the greatest challenges in modern psychiatry. It is essential to differentiate various forms of depression, dysthymia, and dysphoric mixed states of bipolar disorders from the clinical features of more common, unipolar major depressive disorders. In bipolar depression, antidepressant responses often are unsatisfactory, and these agents probably are overused. Emerging treatments, including several anticonvulsant and modern antipsychotic drugs, as well as lithium-alone or in selected combinations-are partially effective for bipolar depression. Interest in recognizing bipolar depression and seeking more effective, specific, and safer treatments for it are growing.
authors.affiliation: Harvard Medical School, McLean Hospital, Belmont, MA, USA. rjb@mclean.org <rjb@mclean.org>
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D004359:Drug Therapy, Combination; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds