Pharmacological treatment of acute bipolar depression
Acute depression is the condition for which bipolar patients most often seek treatment. The foundation of evidence-based practice is the practitioner’s obligation to inform the patient of proven therapies that may exist to treat their condition. The best guidance for meeting this obligation in clinical practice comes from double-blind, placebo-controlled trials with adequate sample size, referred to in this chapter as Category A evidence. This level of evidence is currently available for only four pharmacological treatments, lamotrigine, olanzapine plus fluoxetine, olanzapine monotherapy, and quetiapine. Interestingly, the most common treatment for bipolar depression — the adjunctive use of standard antidepressants along with lithium or valproate — has not been shown to be effective in any Category A study. Additional treatments for bipolar depression are needed for the many depressed bipolar patients who do not respond adequately to currently available treatments. Several classes of medications show promise for these patients. Exploring the variety of mechanisms by which these medications work may shed light on the pathophysiology of bipolar disorder.
KeywordsBipolar Disorder Mood Stabilizer Bipolar Patient Bipolar Depression Olanzapine Monotherapy
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