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An update on the treatment of bipolar depression.

Author(s): Azorin JM, Kaladjian A

Affiliation(s): Pole Universitaire de Psychiatrie-Solaris, Hopital Ste Marguerite, 13274 Marseille Cedex 9, France. jazorin@ap-hm.fr

Publication date & source: 2009-02, Expert Opin Pharmacother., 10(2):161-72.

Publication type: Review

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.

Page last updated: 2009-10-20

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