Introduction The practical management of bipolar depression represents one of the greatest challenges for the clinician concerned with the treatment of this illness. As discussed elsewhere in this book, bipolar disorder (BD) is common, and much of the considerable disability associated with this illness is due to the depressed phase (Post et al., 2003); patients with bipolar depression have significant psychosocial impairment (Michalak et al., 2008). In addition to this predominant depression, patients suffer higher mortality rates than other bipolar patients, and depression is a major risk factor for suicide in BD (Angst et al., 2005). Pharmacotherapy is the mainstay of treatment, although both psychological and somatic treatment strategies may also be utilised. This chapter will briefly outline the evidence base for current pharmacotherapeutic practice. For a more extensive discussion and specific treatment recommendations, the reader is referred to more comprehensive reviews (Calabrese et al., 2009; Young & Nemeroff, 2009). Pharmacotherapy: focus on bipolar disorder type I depression Lithium A review of the older literature revealed that lithium was significantly more effective than placebo for the treatment of bipolar depression, and approximately half of the patients experienced a relapse of depressive symptoms when lithium was substituted by placebo (Srisurapanont et al., 1995). However, a more recent double-blind, randomised, placebo-controlled study of quetiapine and lithium as acute monotherapy treatment for bipolar depression found no statistically significant difference between lithium and placebo (Young et al., 2010).
|Original language||English (US)|
|Title of host publication||Practical Management of Bipolar Disorder|
|Publisher||Cambridge University Press|
|Number of pages||9|
|ISBN (Print)||9780511776922, 9780521734899|
|State||Published - Jan 1 2010|
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