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Pharmacological treatment of acute bipolar depression

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Book cover Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy

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

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Abstract

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.

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Author information

Authors and Affiliations

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

    Gary S. Sachs, Louisa G. Sylvia & Hannah G. Lund

Authors
  1. Gary S. Sachs
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  2. Louisa G. Sylvia
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  3. Hannah G. Lund
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Editor information

Editors and Affiliations

  1. Mood Disorders Research Unit Laboratory of Molecular Pathophysiology, National Institute of Mental Health Mark O. Hatfield Clinical Research Center, Unit 7SE Rm. 7-3445 10 Center Drive, Bethesda, Maryland, 20892, USA

    Carlos A. Zarate

  2. Laboratory of Molecular Pathophysiology, National Institute of Mental Health Porter Neuroscience Research Center, Building 35, Room 1C-917 36 Convent Drive, MSC 3711, Bethesda, Maryland, 20892, USA

    Husseini K. Manji

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© 2009 Birkhäuser Verlag/Switzerland

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Sachs, G.S., Sylvia, L.G., Lund, H.G. (2009). Pharmacological treatment of acute bipolar depression. In: Zarate, C.A., Manji, H.K. (eds) Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy. Milestones in Drug Therapy. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8567-5_9

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