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Article contents

Case Studies in Bipolar Depression: Best Practices for the Outpatient

Published online by Cambridge University Press:  07 November 2014

Extract

Clinicians are fairly comfortable with the management of acute mania because of the abundance of research studies available. However, there are several important aspects of bipolar disorder that the field has been far less successful with, including management of acute and preventive treatment of bipolar depression, comorbid illnesses, and break-through depression in the context of long-term treatment. There is tremendous complexity in the various symptoms and behavioral dimensions associated with bipolar depression. To facilitate understanding of bipolar depression, this article focuses on treating and managing the bipolar outpatient at risk for a depressive relapse. The discussion poses several challenges associated with bipolar depression and addresses the morbidity of depressive states as well as acute and long-term management of this disorder. The best practices for the varying clinical states of bipolar depressive disorder will be demonstrated through two case examples of patients struggling with disturbances common in bipolar patients.

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Expert Roundtable Supplement
Copyright
Copyright © Cambridge University Press 2007

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References

1.Judd, LL, Akiskal, HS, Schettler, PJ, et al.The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59(6):530537.CrossRefGoogle ScholarPubMed
2.Judd, LL, Akiskal, HS, Schettler, PJ, et al.A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry. 2003;60(3):261269.CrossRefGoogle ScholarPubMed
3.Judd, LL, Akiskal, HS, Schettler, PJ, et al.Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study. Arch Gen Psychiatry. 2005;62(12):13221330.CrossRefGoogle ScholarPubMed
4.Gijsman, HJ, Geddes, JR, Rendell, JM, Nolen, WA, Goodwin, GM. Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiatry. 2004;161(9):15371547.CrossRefGoogle ScholarPubMed
5.Nemeroff, CB, Evans, DL, Gyulai, L, et al.Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. Am J Psychiatry. 2001;158(6):906912.CrossRefGoogle ScholarPubMed
6.Post, RM, Altshuler, LL, Leverich, GS, et al.Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. Br J Psychiatry. 2006;189:124131.CrossRefGoogle ScholarPubMed
7.Sachs, GS, Nierenberg, AA, Calabrese, JR, et al.Effectiveness of adjunctive antidepressant treatment for bipolar depression. NEJM. 2007;356:17111722.CrossRefGoogle ScholarPubMed
8.Calabrese, JR, Bowden, CL, Sachs, GS, Ascher, JA, Monaghan, E, Rudd, GD, and the Lamictal 602 Study Group. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. J Clin Psychiatry. 1999;60(2):7988.CrossRefGoogle ScholarPubMed
9.Tohen, M, Vieta, E, Calabrese, J, et al.Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry. 2003;60(11):10791088.CrossRefGoogle ScholarPubMed
10.Corya, SA, Perlis, RH, Keck, PE Jr, et al.A 24-week open-label extension study of olanzapine-fluoxetine combination and olanzapine monotherapy in the treatment of bipolar depression. J Clin Psychiatry. 2006;67(5):798806.CrossRefGoogle ScholarPubMed
11.Shi, L, Namjoshi, MA, Swindle, R, et al.Effects of olanzapine alone and olanzapine/fluoxetine combination on health-related quality of life in patients with bipolar depression: secondary analyses of a double-blind, placebo-controlled, randomized clinical trial. Clin Ther. 2004;26(1):125134.CrossRefGoogle ScholarPubMed
12.Calabrese, JR, Keck, PE Jr, Macfadden, W, et al.A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. Am J Psychiatry. 2005;162(7):13511360.CrossRefGoogle ScholarPubMed
13.Thase, ME, Macfadden, W, Weisler, RH, et al, and the BOLDER II Study Group. Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled study (the BOLDER II study). J Clin Psychopharmacol. 2006;26(6):600609.CrossRefGoogle Scholar
14.Nierenberg, AA, Ostacher, MJ, Calabrese, JR, et al.Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. Am J Psychiatry. 2006;163(2):210216.CrossRefGoogle ScholarPubMed
15.Goodwin, FK, Jamison, KR. Manic-Depressive Illness. New York, NY: Oxford University Press; 1990.Google Scholar
16.Wehr, TA, Goodwin, FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry. 1987;144(11):14031411.Google ScholarPubMed
17.Gijsman, HJ, Geddes, JR, Rendell, JM, Nolen, WA, Goodwin, GM. Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiatry. 2004;161(9):15371547.CrossRefGoogle ScholarPubMed
18.Angst, J, Gamma, A, Benazzi, F, Ajdacic, V, Eich, D, Rossler, W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord. 2003;73:133146.CrossRefGoogle Scholar
19.Suppes, T, Dennehy, EB, Hirschfeld, RM, et al, and the Texas Consensus Conference Panel on Medication Treatment of Bipolar Disorder. The Texas implementation of medication algorithms: update to the algorithms for treatment of bipolar I disorder. J Clin Psychiatry. 2005;66(7):870886.CrossRefGoogle ScholarPubMed

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