This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

ASCP Corner

What Constitutes Evidence-Based Pharmacotherapy for Bipolar Disorder? Part 2: Complex Presentations and Clinical Context

Joseph F. Goldberg, MD

Published: March 14, 2008

Article Abstract

Because this piece has no abstract, we have provided for your benefit the first 3 sentences of the full text.

Part 1 of this ASCP CORNER examinedgeneral principles of evidence-based medicine(EBM) regarding first-line pharmacotherapiesacross illness phases of bipolardisorder.1 We shall now consider evidencebasedpharmacotherapy for clinical presentationsthat fall outside the usual andcustomary realm—for example, due toatypical (e.g., “not otherwise specified”[NOS]) or mixed affective features, coursespecifiers (e.g., rapid cycling), true comorbidities,or frank treatment resistance.Since many patients with bipolar disorderare neither usual nor customary, those with”non-prototypical” features may well comprisethe majority of treatment-seekingpatients.

EBM discourages sweeping overgeneralizations(e.g., “Aminoglycosides aregood antibiotics”), instead linking drugutility with context (e.g., “Aminoglycosidesare good antibiotics for gram-negative infectionsin renally intact patients”); hence,distinct clinical contexts (e.g., “Quetiapinetreats depression in bipolar II patients withrapid cycling”) may offer more useful waysof thinking than unspecified clinical contexts(e.g., “Is quetiapine useful for bipolardisorder?”).’ ‹’ ‹


Some JCP and PCC articles are available in PDF format only. Please click the PDF link at the top of this page to access the full text.

Related Articles

Volume: 69

Quick Links: Bipolar Disorder

References

Sign-up to stay
up-to-date today!

SUBSCRIBE

Already registered? Sign In

Original Research

Frontothalamic Circuit Abnormalities in Patients With Bipolar Depression and Suicide Attempts

To identify potential markers for suicide risk, this fMRI study looked at neural activity in bipolar depression...

Read More...