Skip to main content
SpringerLink
Log in
Book cover

Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis, and Pharmacotherapy pp 185–211Cite as

Pharmacological Treatment of Acute Bipolar Depression

  • Chapter
  • First Online:

  • 1508 Accesses

Part of the book series: Milestones in Drug Therapy ((MDT))

Abstract

Controversy regarding management of the acute phase of bipolar depression largely reflects the natural divergence of opinions arising from large gaps in knowledge and the fact that no medication is particularly effective in this population. While there remains a great need for more and better evidence from high-quality studies to close the gaps, the past decade has seen the publication of a substantial number of fully powered placebo-controlled trials for bipolar depression, including several new agents. This chapter addresses the challenges of treating bipolar depression by describing a general schema consisting of principles for iterative personalized care that can be applied to an evolving knowledge base. This chapter also reviews the state of the evidence supporting various pharmacological treatments for bipolar depression, including quetiapine, lurasidone, lamotrigine, olanzapine, olanzapine plus fluoxetine (OFC), modafinil, armodafinil, lithium, valproate, carbamazepine, ketamine, N-acetyl cysteine (NAC), inositol, pramipexole, riluzole, and standard antidepressants, among others. Currently, five medications are supported by Category A criteria. In order of the strength of support evidence, these are quetiapine, lurasidone, olanzapine, OFC, and lamotrigine. Regardless of whether patients accept these treatments or begin with alternatives, a measurement-based approach to treatment provides a systematic means of working toward an optimized individual treatment plan.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Altshuler L, Suppes T, Black D, Nolen WA, Keck PE Jr, Frye MA, McElroy S, Kupka R, Grunze H, Walden J, Leverich G, Denicoff K, Luckenbaugh D, Post R (2003) Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up. Am J Psychiatry 160(7):1252–1262

    Article  PubMed  Google Scholar 

  • Altshuler LL, Post RM, Hellemann G, Leverich GS, Nolen WA, Frye MA, Keck PE Jr, Kupka RW, Grunze H, McElroy SL, Sugar CA, Suppes T (2009) Impact of antidepressant continuation after acute positive or partial treatment response for bipolar depression: a blinded, randomized study. J Clin Psychiatry 70(4):450–457

    Article  CAS  PubMed  Google Scholar 

  • Amsterdam JD, Shults J (2010) Efficacy and Safety of Long-Term Fluoxetine Versus Lithium Monotherapy of Bipolar II Disorder: A Randomized, Double-Blind, Placebo-Substitution Study. Am J Psychiatry 167:792–800

    Article  PubMed  PubMed Central  Google Scholar 

  • Amsterdam JD, Garcia-Espana F, Fawcett J, Quitkin FM, Reimherr FW, Rosenbaum JF, Schweizer E, Beasley C (1998) Efficacy and safety of fluoxetine in treating bipolar II major depressive episode. J Clin Psychopharmacol 18(6):435–440

    Article  CAS  PubMed  Google Scholar 

  • Amsterdam JD, Shults J, Brunswick DJ, Hundert M (2004) Short-term fluoxetine monotherapy for bipolar type II or bipolar NOS major depression – low manic switch rate. Bipolar Disord 6(1):75–81

    Article  CAS  PubMed  Google Scholar 

  • Benedetti F, Barbini B, Campori E, Fulgosi MC, Pontiggia A, Colombo C (2001) Sleep phase advance and lithium to sustain the antidepressant effect of total sleep deprivation in bipolar depression: new findings supporting the internal coincidence model? J Psychiatr Res 35(6):323–329

    Article  CAS  PubMed  Google Scholar 

  • Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI (2008) N-acetyl cysteine for depressive symptoms in bipolar disorder – a double-blind randomized placebo-controlled trial. Biol Psychiatry 64(6):468–475

    Article  CAS  PubMed  Google Scholar 

  • Bond DJ, Lam RW, Yatham LN (2010) Divalproex sodium versus placebo in the treatment of acute bipolar depression: A systematic review and meta-analysis. J Affect Disord 124(3):228–34

    Article  CAS  PubMed  Google Scholar 

  • Bowden CL (2001) Strategies to reduce misdiagnosis of bipolar depression. Psychiatr Serv 52(1):51–55

    Article  CAS  PubMed  Google Scholar 

  • Brown EB, McElroy SL, Keck PE Jr, Deldar A, Adams DH, Tohen M, Williamson DJ (2006) A 7-week, randomized, double-blind trial of olanzapine/fluoxetine combination versus lamotrigine in the treatment of bipolar I depression. J Clin Psychiatry 67(7):1025–1033

    Article  CAS  PubMed  Google Scholar 

  • Calabrese JR, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD (1999) A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry 60(2):79–88

    Article  CAS  PubMed  Google Scholar 

  • Calabrese JR, Keck PE Jr, Macfadden W, Minkwitz M, Ketter TA, Weisler RH, Cutler AJ, McCoy R, Wilson E, Mullen J (2005) A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. Am J Psychiatry 162(7):1351–1360

    Article  PubMed  Google Scholar 

  • Calabrese JR, Kemp DE, Ganocy SJ, Brecher M, Carlson BX, Edwards S, Eudicone J, Evoniuk G, Jansen WT, McQuade R, Millen B, Minkwitz M, Owen R, Pikalov A, Szegedi A, Tohen M, Vester-Blokland E, Willigenburg AP (2010a) Knowing when a drug is not going to work in bipolar depression: absence of early improvement as a predictor of later non-response in 3,369 patients from 10 placebo-controlled acute trials. Paper presented at the International Society for Clinical Trial Methodology, Washington, DC

    Google Scholar 

  • Calabrese JR, Ketter TA, Youakim JM, Tiller JM, Yang R, Frye MA (2010b) Adjunctive armodafinil for major depressive episodes associated with bipolar I disorder: a randomized, multicenter, double-blind, placebo-controlled, proof-of-concept study. J Clin Psychiatry 71:1363–1370

    Google Scholar 

  • Calabrese JR, Frye MA, Yang R, Ketter TA, Armodafinil Treatment Trial Study N (2014) Efficacy and safety of adjunctive armodafinil in adults with major depressive episodes associated with bipolar I disorder: a randomized, double-blind, placebo-controlled, multicenter trial. J Clin Psychiatry 75(10):1054–1061

    Google Scholar 

  • Chengappa KN, Levine J, Gershon S, Mallinger AG, Hardan A, Vagnucci A, Pollock B, Luther J, Buttenfield J, Verfaille S, Kupfer DJ (2000) Inositol as an add-on treatment for bipolar depression. Bipolar Disord 2(1):47–55

    Article  CAS  PubMed  Google Scholar 

  • Coryell W, Solomon DA, Fiedorowicz JG, Endicott J, Schettler PJ, Judd LL (2009) Anxiety and outcome in bipolar disorder. Am J Psychiatry 166(11):1238–1243

    Article  PubMed  PubMed Central  Google Scholar 

  • Davis LL, Bartolucci A, Petty F (2005) Divalproex in the treatment of bipolar depression: a placebo-controlled study. J Affect Disord 85(3):259–266

    Article  CAS  PubMed  Google Scholar 

  • Diazgranados N, Ibrahim L, Brutsche NE, Newberg A, Kronstein P, Khalife S, Kammerer WA, Quezado Z, Luckenbaugh DA, Salvadore G, Machado-Vieira R, Manji HK, Zarate CA Jr (2010) A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry 67(8):793–802

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eden Evins A, Demopulos C, Yovel I, Culhane M, Ogutha J, Grandin LD, Nierenberg AA, Sachs GS (2006) Inositol augmentation of lithium or valproate for bipolar depression. Bipolar Disord 8(2):168–174

    Article  CAS  PubMed  Google Scholar 

  • El-Mallakh RS (2000) An open study of methylphenidate in bipolar depression. Bipolar Disord 2(1):56–59

    Article  CAS  PubMed  Google Scholar 

  • Frye MA, Grunze H, Suppes T, McElroy SL, Keck PE Jr, Walden J, Leverich GS, Altshuler LL, Nakelsky S, Hwang S, Mintz J, Post RM (2007) A placebo-controlled evaluation of adjunctive modafinil in the treatment of bipolar depression. Am J Psychiatry 164(8):1242–1249

    Article  PubMed  Google Scholar 

  • Gao K, Wu R, Kemp DE, Chen J, Karberg E, Conroy C, Chan P, Ren M, Serrano MB, Ganocy SJ, Calabrese JR (2014) Efficacy and safety of quetiapine-XR as monotherapy or adjunctive therapy to a mood stabilizer in acute bipolar depression with generalized anxiety disorder and other comorbidities: a randomized, placebo-controlled trial. J Clin Psychiatry 75(10):1062–1068

    Article  PubMed  Google Scholar 

  • Geddes JR, Calabrese JR, Goodwin GM (2009) Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials. Br J Psychiatry 194(1):4–9

    Article  PubMed  Google Scholar 

  • Gijsman HJ, Geddes JR, Rendell JM, Nolen WA, Goodwin GM (2004) Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiatry 161(9):1537–1547

    Article  PubMed  Google Scholar 

  • Goldberg JF, Burdick KE, Endick CJ (2004) Preliminary randomized, double-blind, placebo-controlled trial of pramipexole added to mood stabilizers for treatment-resistant bipolar depression. Am J Psychiatry 161(3):564–566

    Article  PubMed  Google Scholar 

  • Himmelhoch JM, Thase ME, Mallinger AG, Houck P (1991) Tranylcypromine versus imipramine in anergic bipolar depression. Am J Psychiatry 148(7):910–916

    Article  CAS  PubMed  Google Scholar 

  • Ionescu DF, Luckenbaugh DA, Niciu MJ, Richards EM, Zarate CA Jr (2015) A single infusion of ketamine improves depression scores in patients with anxious bipolar depression. Bipolar Disord 17(4):438–443

    Article  CAS  PubMed  Google Scholar 

  • Joffe RT, MacQueen GM, Marriott M, Trevor Young L (2004) A prospective, longitudinal study of percentage of time spent ill in patients with bipolar I or bipolar II disorders. Bipolar Disord 6(1):62–66

    Article  PubMed  Google Scholar 

  • Johnson SL, Brickman AL (2006) Diagnostic inconsistency: a marker of service utilization in bipolar disorder. Manag Care Interface 19(4):41–45

    PubMed  Google Scholar 

  • Judd LL, Schettler PJ, Akiskal HS, Maser J, Coryell W, Solomon D, Endicott J, Keller M (2003) Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol 6(2):127–137

    Article  PubMed  Google Scholar 

  • Keck PE Jr, Mintz J, McElroy SL, Freeman MP, Suppes T, Frye MA, Altshuler LL, Kupka R, Nolen WA, Leverich GS, Denicoff KD, Grunze H, Duan N, Post RM (2006) Double-blind, randomized, placebo-controlled trials of ethyl-eicosapentanoate in the treatment of bipolar depression and rapid cycling bipolar disorder. Biol Psychiatry 60(9):1020–1022

    Article  CAS  PubMed  Google Scholar 

  • Keller MB, Hanks DL, Klein DN (1996) Summary of the DSM-IV mood disorders field trial and issue overview. Psychiatr Clin North Am 19(1):1–28

    Article  CAS  PubMed  Google Scholar 

  • Kelly TF, Lieberman DZ (2014) The utility of the combination of dextromethorphan and quinidine in the treatment of bipolar II and bipolar NOS. J Affect Disord 167:333–335

    Article  CAS  PubMed  Google Scholar 

  • Kemp DE, Ganocy SJ, Brecher M, Carlson BX, Edwards S, Eudicone JM, Evoniuk G, Jansen W, Leon AC, Minkwitz M, Pikalov A, Stassen HH, Szegedi A, Tohen M, Van Willigenburg AP, Calabrese JR (2011a) Clinical value of early partial symptomatic improvement in the prediction of response and remission during short-term treatment trials in 3369 subjects with bipolar I or II depression. J Affect Disord 130(1–2):171–179

    Article  PubMed  Google Scholar 

  • Kemp DE, Johnson E, Wang WV, Tohen M, Calabrese JR (2011b) Clinical utility of early improvement to predict response or remission in acute mania: focus on olanzapine and risperidone. J Clin Psychiatry 72:1236–1241

    Article  CAS  PubMed  Google Scholar 

  • Klerman GL (1990) The psychiatric patient's right to effective treatment: implications of Osheroff v. Chestnut Lodge. Am J Psychiatry 147(4):409–418

    Article  CAS  PubMed  Google Scholar 

  • Lambert PA, Carraz G, Borselli S (1966) Action neuropsychotrope d'un novel anti-epileptique: le Depamide [French]. Ann Med Psychol 1:707–710

    Google Scholar 

  • Lee EE, Della Selva MP, Liu A, Himelhoch S (2015) Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis. Gen Hosp Psychiatry 37(2):178–184

    Article  PubMed  Google Scholar 

  • Leverich GS, Altshuler LL, Frye MA, Suppes T, McElroy SL, Keck PE Jr, Kupka RW, Denicoff KD, Nolen WA, Grunze H, Martinez MI, Post RM (2006) Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am J Psychiatry 163(2):232–239

    Article  PubMed  Google Scholar 

  • Levine J, Barak Y, Gonzalves M, Szor H, Elizur A, Kofman O, Belmaker RH (1995) Double-blind, controlled trial of inositol treatment of depression. Am J Psychiatry 152(5):792–794

    Article  CAS  PubMed  Google Scholar 

  • Loebel A, Cucchiaro J, Silva R, Kroger H, Hsu J, Sarma K, Sachs G (2014a) Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry 171(2):160–168

    Article  PubMed  Google Scholar 

  • Loebel A, Cucchiaro J, Silva R, Kroger H, Sarma K, Xu J, Calabrese JR (2014b) Lurasidone as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry 171(2):169–177

    Article  PubMed  Google Scholar 

  • Loebel A, Cucchiaro J, Silva R, Hsu J, Sarma K (2015) Double blind placebo controlled trial of Lurasidone vs placebo for treatment of unipolar major depressive episode with mixed features. In: Annual meeting American Psychaitric Association, Toronto

    Google Scholar 

  • McElroy SL, Weisler RH, Chang W, Olausson B, Paulsson B, Brecher M, Agambaram V, Merideth C, Nordenhem A, Young AH (2010) A double-blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II). J Clin Psychiatry 71(2):163–174

    Article  CAS  PubMed  Google Scholar 

  • Nemeroff CB, Evans DL, Gyulai L, Sachs GS, Bowden CL, Gergel IP, Oakes R, Pitts CD (2001) Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. Am J Psychiatry 158(6):906–912

    Article  CAS  PubMed  Google Scholar 

  • Nemets H, Nemets B, Apter A, Bracha Z, Belmaker RH (2006) Omega-3 treatment of childhood depression: a controlled, double-blind pilot study. Am J Psychiatry 163(6):1098–1100

    Article  PubMed  Google Scholar 

  • Nierenberg AA, Farabaugh AH, Alpert JE, Gordon J, Worthington JJ, Rosenbaum JF, Fava M (2000) Timing of onset of antidepressant response with fluoxetine treatment. Am J Psychiatry 157(9):1423–1428

    Article  CAS  PubMed  Google Scholar 

  • Nierenberg AA, Ostacher MJ, Calabrese JR, Ketter TA, Marangell LB, Miklowitz DJ, Miyahara S, Bauer MS, Thase ME, Wisniewski SR, Sachs GS (2006) Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. Am J Psychiatry 163(2):210–216

    Article  PubMed  Google Scholar 

  • Nolen WA, Kupka RW, Hellemann G, Frye MA, Altshuler LL, Leverich GS, Suppes T, Keck PE Jr, McElroy S, Grunze H, Mintz J, Post RM (2007) Tranylcypromine vs. lamotrigine in the treatment of refractory bipolar depression: a failed but clinically useful study. Acta Psychiatr Scand 115(5):360–365

    Article  CAS  PubMed  Google Scholar 

  • Osher Y, Bersudsky Y, Belmaker RH (2005) Omega-3 eicosapentaenoic acid in bipolar depression: report of a small open-label study. J Clin Psychiatry 66(6):726–729

    Article  CAS  PubMed  Google Scholar 

  • Ostacher MJ (2014) When positive isn’t positive: the hopes and disappointments of clinical trials. J Clin Psychiatry 75(10):e1186–e1187

    Article  PubMed  Google Scholar 

  • Pacchiarotti I, Bond DJ, Baldessarini RJ, Nolen WA, Grunze H, Licht RW, Post RM, Berk M, Goodwin GM, Sachs GS, Tondo L, Findling RL, Youngstrom EA, Tohen M, Undurraga J, Gonzalez-Pinto A, Goldberg JF, Yildiz A, Altshuler LL, Calabrese JR, Mitchell PB, Thase ME, Koukopoulos A, Colom F, Frye MA, Malhi GS, Fountoulakis KN, Vazquez G, Perlis RH, Ketter TA, Cassidy F, Akiskal H, Azorin JM, Valenti M, Mazzei DH, Lafer B, Kato T, Mazzarini L, Martinez-Aran A, Parker G, Souery D, Ozerdem A, McElroy SL, Girardi P, Bauer M, Yatham LN, Zarate CA, Nierenberg AA, Birmaher B, Kanba S, El-Mallakh RS, Serretti A, Rihmer Z, Young AH, Kotzalidis GD, MacQueen GM, Bowden CL, Ghaemi SN, Lopez-Jaramillo C, Rybakowski J, Ha K, Perugi G, Kasper S, Amsterdam JD, Hirschfeld RM, Kapczinski F, Vieta E (2013) The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. Am J Psychiatry 170(11):1249–1262

    Article  PubMed  PubMed Central  Google Scholar 

  • Post RM, Uhde TW, Roy-Byrne PP, Joffe RT (1986) Antidepressant effects of carbamazepine. Am J Psychiatry 143(1):29–34

    Article  CAS  PubMed  Google Scholar 

  • Post RM, Altshuler LL, Leverich GS, Frye MA, Nolen WA, Kupka RW, Suppes T, McElroy S, Keck PE, Denicoff KD, Grunze H, Walden J, Kitchen CM, Mintz J (2006) Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. Br J Psychiatry 189:124–131

    Article  CAS  PubMed  Google Scholar 

  • Revicki DA, Hanlon J, Martin S, Gyulai L, Nassir Ghaemi S, Lynch F, Mannix S, Kleinman L (2005) Patient-based utilities for bipolar disorder-related health states. J Affect Disord 87(2–3):203–210

    Article  PubMed  Google Scholar 

  • Riemann D, Voderholzer U, Berger M (2002) Sleep and sleep-wake manipulations in bipolar depression. Neuropsychobiology 45(Suppl 1):7–12

    Article  PubMed  Google Scholar 

  • Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN, Markowitz JC, Ninan PT, Kornstein S, Manber R, Thase ME, Kocsis JH, Keller MB (2003) The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry 54(5):573–583

    Article  PubMed  Google Scholar 

  • Rush AJ, Kraemer HC, Sackeim HA, Fava M, Trivedi MH, Frank E, Ninan PT, Thase ME, Gelenberg AJ, Kupfer DJ, Regier DA, Rosenbaum JF, Ray O, Schatzberg AF (2006) Report by the ACNP Task Force on response and remission in major depressive disorder. Neuropsychopharmacology 31(9):1841–1853

    Article  PubMed  Google Scholar 

  • Sachs GS (2004a) Effectiveness study design and preliminary finding from STEP-BD. In: 59th Annual Convention Society for Biological Psychiatry, New York, NY

    Google Scholar 

  • Sachs GS (2004b) Strategies for improving treatment of bipolar disorder: integration of measurement and management. Acta Psychiatr Scand Suppl (422):7–17

    Google Scholar 

  • Sachs GS (2007) Bipolar disorder clinical synthesis: Where does the evidence lead? Focus V(1):1–11

    Google Scholar 

  • Sachs GS, Lafer B, Stoll AL, Banov M, Thibault AB, Tohen M, Rosenbaum JF (1994) A double-blind trial of bupropion versus desipramine for bipolar depression. J Clin Psychiatry 55(9):391–393

    CAS  PubMed  Google Scholar 

  • Sachs GA, Ketter L, Suppes T, Rasgon N, Frey M, Collins M (2002) Divalproex versus placebo for treatment of Bipolar depression. In: 155th Annual Meeting of the American Psychiatric Association, Philadelphia, PA

    Google Scholar 

  • Sidor MM, Macqueen GM (2011) Antidepressants for the acute treatment of bipolar depression: a systematic review and meta-analysis. J Clin Psychiatry 72(2):156–167

    Article  CAS  PubMed  Google Scholar 

  • Silverstone T (2001) Moclobemide vs. imipramine in bipolar depression: a multicentre double-blind clinical trial. Acta Psychiatr Scand 104(2):104–109

    Article  CAS  PubMed  Google Scholar 

  • Speer AM, Kimbrell TA, Wassermann EM, D Repella J, Willis MW, Herscovitch P, Post RM (2000) Opposite effects of high and low frequency rTMS on regional brain activity in depressed patients. Biol Psychiatry 48(12):1133–1141

    Article  CAS  PubMed  Google Scholar 

  • Suppes T, Datto C, Minkwitz M, Nordenhem A, Walker C, Darko D (2010) Effectiveness of the extended release formulation of quetiapine as monotherapy for the treatment of acute bipolar depression. J Affect Disord 121(1–2):106–115

    Article  CAS  PubMed  Google Scholar 

  • Szegedi A, Jansen WT, van Willigenburg AP, van der Meulen E, Stassen HH, Thase ME (2009) Early improvement in the first 2 weeks as a predictor of treatment outcome in patients with major depressive disorder: a meta-analysis including 6562 patients. J Clin Psychiatry 70(3):344–353

    Article  PubMed  Google Scholar 

  • Takayanagi Y, Spira AP, Roth KB, Gallo JJ, Eaton WW, Mojtabai R (2014) Accuracy of reports of lifetime mental and physical disorders: results from the Baltimore Epidemiological Catchment Area study. JAMA Psychiatry 71(3):273–280

    Article  PubMed  PubMed Central  Google Scholar 

  • Thase ME, Macfadden W, Weisler RH, Chang W, Paulsson B, Khan A, Calabrese JR, Group BIS (2006) Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled study (the BOLDER II study). J Clin Psychopharmacol 26(6):600–609

    Article  CAS  PubMed  Google Scholar 

  • Tohen M, Vieta E, Calabrese J, Ketter TA, Sachs G, Bowden C, Mitchell PB, Centorrino F, Risser R, Baker RW, Evans AR, Beymer K, Dube S, Tollefson GD, Breier A (2003) Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry 60(11):1079–1088

    Article  CAS  PubMed  Google Scholar 

  • Tohen M, Calabrese JR, Sachs GS, Banov MD, Detke HC, Risser R, Baker RW, Chou JC, Bowden CL (2006) Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine. Am J Psychiatry 163(2):247–256

    Article  PubMed  Google Scholar 

  • Tohen M, McDonnell DP, Case M, Kanba S, Ha K, Fang YR, Katagiri H, Gomez JC (2012) Randomised, double-blind, placebo-controlled study of olanzapine in patients with bipolar I depression. Br J Psychiatry 201(5):376–382

    Article  PubMed  Google Scholar 

  • van der Loos ML, Mulder PG, Hartong EG, Blom MB, Vergouwen AC, de Keyzer HJ, Notten PJ, Luteijn ML, Timmermans MA, Vieta E, Nolen WA (2009) Efficacy and safety of lamotrigine as add-on treatment to lithium in bipolar depression: a multicenter, double-blind, placebo-controlled trial. J Clin Psychiatry 70(2):223–231

    Article  PubMed  Google Scholar 

  • Vieta E, Martinez-Aran A, Goikolea JM, Torrent C, Colom F, Benabarre A, Reinares M (2002) A randomized trial comparing paroxetine and venlafaxine in the treatment of bipolar depressed patients taking mood stabilizers. J Clin Psychiatry 63(6):508–512

    Article  CAS  PubMed  Google Scholar 

  • Young AH, McElroy SL, Bauer M, Philips N, Chang W, Olausson B, Paulsson B, Brecher M (2010) A double-blind, placebo-controlled study of quetiapine and lithium monotherapy in adults in the acute phase of bipolar depression (EMBOLDEN I). J Clin Psychiatry 71(2):150–162

    Article  CAS  PubMed  Google Scholar 

  • Young AH, Calabrese JR, Gustafsson U, Berk M, McElroy SL, Thase ME, Suppes T, Earley W (2013) Quetiapine monotherapy in bipolar II depression: combined data from four large, randomized studies. Int J Bipolar Disord 1:10

    Article  PubMed  PubMed Central  Google Scholar 

  • Zarate CA Jr, Payne JL, Singh J, Quiroz JA, Luckenbaugh DA, Denicoff KD, Charney DS, Manji HK (2004) Pramipexole for bipolar II depression: a placebo-controlled proof of concept study. Biol Psychiatry 56(1):54–60

    Article  CAS  PubMed  Google Scholar 

  • Zarate CA Jr, Quiroz JA, Singh JB, Denicoff KD, De Jesus G, Luckenbaugh DA, Charney DS, Manji HK (2005) An open-label trial of the glutamate-modulating agent riluzole in combination with lithium for the treatment of bipolar depression. Biol Psychiatry 57(4):430–432

    Article  CAS  PubMed  Google Scholar 

  • Zarate CA Jr, Brutsche NE, Ibrahim L, Franco-Chaves J, Diazgranados N, Cravchik A, Selter J, Marquardt CA, Liberty V, Luckenbaugh DA (2012) Replication of ketamine's antidepressant efficacy in bipolar depression: a randomized controlled add-on trial. Biol Psychiatry 71(11):939–946

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bipolar Clinic and Research Program, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA

    Gary S. Sachs MD

Authors
  1. Gary S. Sachs MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gary S. Sachs MD .

Editor information

Editors and Affiliations

  1. Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA

    Carlos A. Zarate Jr.

  2. Janssen Pharmaceuticals of Johnson and Johnson, Janssen Research and Development, Titusville, New Jersey, USA

    Husseini K. Manji

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland (outside the USA)

About this chapter

Cite this chapter

Sachs, G.S. (2016). Pharmacological Treatment of Acute Bipolar Depression. In: Zarate Jr., C., Manji, H. (eds) Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis, and Pharmacotherapy. Milestones in Drug Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-31689-5_9

Download citation

Publish with us

Policies and ethics

Search

Navigation