An update on the treatment of bipolar depression.

Expert Opin Pharmacother

Pôle Universitaire de Psychiatrie-Solaris, Hôpital Ste Marguerite, 13274 Marseille Cedex 9, France.

Published: February 2009

Background: Although depression accounts for a large part of the burden associated with bipolar disorder, its drug treatment has been under-studied.

Objective: To provide the best available evidence supporting the pharmacotherapy of bipolar depression.

Methods: A systematic review was conducted, focusing on randomized, controlled trials (RCTs) and meta-analyses.

Results/conclusions: Despite FDA approval of both the olanzapine-fluoxetine combination and quetiapine for the treatment of acute bipolar depression, independent RCTs (i.e., not trials conducted 'under the umbrella' of a drug company) have not found any drug to have antidepressant effects similar to those seen in unipolar depression. A practice-based suggestion, valuable for both short- and long-term treatment, might be to have a background of mood stabilizers and to add drugs, following one of several treatment options, trusting to find a drug with a degree of effectiveness by trial and error. The list of drugs that could be used would include all the current antidepressants, the olanzapine-fluoxetine combination and probably quetiapine too. Special features and situations might also influence treatment options.

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Source
http://dx.doi.org/10.1517/14656560802653172DOI Listing

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