bipolar disorder has a negative impact on the lives of millions. Yet
treatment for bipolar depression has come a long way from when patients were
drugged with heavy, sedating tranquilizers just a few decades ago. Today, the mainstay of treatments for
bipolar disorder may include mood stabilizing drugs. These include drugs such
as lithium, or an antipsychotic medication, or a
combination of these medications -- all with the goal of modulating moods
without igniting a manic episode.
While depression episodes are far
more common than mania and have a tremendous effect on the lives of
patients, few studies are available on understanding bipolar depression and how
it is best treated.
Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal behavior that disrupts life.
Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. This is...
What's the standard treatment for bipolar depression?
According to the second edition of
the American Psychiatric Association's practice guidelines, first-line
medication therapy for acute depression in patients with bipolar disorder is
either lithium or the anticonvulsant
lamotrigine. Both lithium and lamotrigine are mood stabilizers. For
severely ill patients lithium and an antidepressant are sometimes used.
A mood-stabilizing medication works on improving social interactions, mood,
and behavior and is recommended for both treatment and prevention of bipolar
mood states that swing from the lows of depression to the highs of hypomania or
mania. According to the American
Psychiatric Association (APA), lithium, lamotrigine, valproate,
carbamazepine, and most atypical antipsychotic medications are approved by
the FDA for treating one (or more) phases of bipolar disorder.
In some patients with bipolar disorder, a mood stabilizer may be all that's
needed to modulate the depressed mood. However, in bipolar patients who do not
respond to one mood stabilizer, another mood stabilizer or an atypical
antipsychotic should be added to the treatment regimen.
Are antidepressants used to treat bipolar depression?
are effective treatment for major
depression, antidepressants should not be given alone (monotherapy)
with bipolar depression. When antidepressants are given alone to someone with
bipolar disorder, there's a risk the
drug might ignite a manic episode in some patients. Knowing this, most
doctors may avoid using antidepressants as monotherapy for bipolar
Using mood stabilizers instead of antidepressants to treat bipolar
depression is supported by the STEP-BD study - the largest study of its kind
that continues to evaluate all the best-practice treatment modalities used for
people with bipolar disorder, including the use of mood-stabilizing
medications, antidepressants, atypical antipsychotics, and psychosocial