Improving Outcomes in Patients With Bipolar Depression: A Comprehensive Review

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Only 3 medications are currently approved in the US for acute bipolar depression: 2 atypical antipsychotics and a combination atypical antipsychotic–selective serotonin reuptake inhibitor. Metabolic, neurologic, and hormonal adverse events are associated with all of the atypical antipsychotics approved for this indication. However, these agents differ in their propensity to cause weight gain or other side effects that significantly impact a patient’s physical health and ability to function, and the selection of medication—which may also include a mood stabilizer—as well as other forms of treatment, will affect the outcome. It is important to design treatment based on individual needs. Evidence suggests that the collaborative care model, which incorporates individualized systematic treatment, may be more appropriate for the management of bipolar depression than the acute care model.

From the Department of Psychiatry and the Depression Clinical and Research Program, Harvard Medical School and Massachusetts General Hospital, Boston (Dr Nierenberg); the Departments of Psychiatry and Pharmacology, University of Toronto, and the Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada (Dr McIntyre); and the Department of Psychiatry, Harvard Medical School, and the Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston (Dr Sachs).

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J Clin Psychiatry 2015;76(3):e10

https://doi.org/10.4088/JCP.13091ip1