Bipolar Depression: How Can We Treat It More Effectively?

Summary: While mania is a hallmark of bipolar disorder, the depressive phase is the main driver of treatment resistance, functional disability, and suicidality. Although there are five FDA-approved antipsychotic treatments for bipolar depression, new approaches are needed to reframe and manage the depressive phase in bipolar disorder. This article reviews the controversy surrounding the use of stimulants for bipolar depression, summarizes approved recommendations, discusses mechanisms of action, and compares risks and benefits to provide a new perspective on individualized care and novel treatment strategies.

Summary: Psychotherapy plays a crucial role in managing bipolar depression and its impairments, and it has been proven to effectively complement pharmacotherapy in delaying or preventing episodes of bipolar depression. However, individuals with bipolar depression may have reservations about considering these treatments. This paper provides a survey on the usefulness, evidence base, effective treatment components, and controversies surrounding adjunctive psychosocial interventions.

Summary: The use of antidepressants in the treatment of bipolar disorder (BD) remains a controversial topic, despite the limited and inconsistent evidence supporting their safety and effectiveness. This article reviews the clinical and meta-analytical evidence on the efficacy and safety of antidepressants in both types of BD and emphasizes the importance of considering the potential risks and benefits for individual patients based on their characteristics and treatment outcomes.