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Newer treatment studies for bipolar depression.
Keming Gao1, Joseph R Calabrese
1NIMH Bipolar Research Center, Mood Disorders Program, University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, OH, USA. keming.gao@uhhs.com
Bipolar Disorders
|October 18, 2005
Summary
Several treatments show promise for bipolar depression, with olanzapine, olanzapine-fluoxetine combination, and quetiapine effective for acute episodes. Lamotrigine excels in preventing depressive relapses.
Area of Science:
- Psychiatry
- Pharmacology
- Neuroscience
Background:
- Depressive symptoms significantly impair quality of life in bipolar disorder.
- Effective treatments for bipolar depression are crucial for patient well-being.
Purpose of the Study:
- To review emerging efficacy data for treatments targeting bipolar depression.
- To identify effective acute and maintenance therapies for bipolar depression.
Main Methods:
- Systematic literature search of Medline for randomized, placebo-controlled trials.
- Prioritization of newer agents and inclusion of open-label studies for novel agents.
- Inclusion of studies on older agents and novel treatments for bipolar depression.
Main Results:
- Olanzapine, olanzapine-fluoxetine combination (OFC), and quetiapine demonstrated superiority over placebo in acute treatment.
- Lamotrigine, pramipexole, omega-3 fatty acids, and agomelatine showed efficacy in specific contexts.
- Lamotrigine and olanzapine were superior to placebo in preventing depressive relapses; agents were generally well tolerated.
Conclusions:
- Olanzapine, OFC, and quetiapine are effective for acute bipolar depression treatment.
- Lamotrigine is more effective than lithium and divalproex for preventing bipolar depression.
- Further controlled studies are needed for other agents in acute and maintenance treatment.