In recent years,many papers on the treatment of the depressive phase of bipolar disorder (bipolar depression), especially bipolar I disorder, with high-level evidence, have been reported. The results of meta-analyses have also been reported for some medications. In the pharmacotherapy for bipolar depression, quetiapine(300mg/day), lithium(more than 0.8mEq/L), olanzapine(5-20mg/day)and lamotrigine(200mg/day)are effective,with highlevel evidence. The combination of lithium and lamotrigine is also effective for bipolar depression. There is no evidence for effectiveness of the combination of mood stabilizers and antidepressants for bipolar depression. This paper presents the evidence data of quetiapine, lithium, olanzapine, lamotrigine, carbamazepine, valproate, aripiprazole, antidepressants, a combination of medications, and electroconvulsive therapy for bipolar depression, based on large-size randomized controlled studies and meta-analyses. The first-line medications for bipolar depression in the practice guidelines published for the last three years are also included.
Evidence of Treatment for Depressive Episode of Bipolar Disorder
Department of Psychiatry, Tokyo Women’s Medical University, Medical Center East
Psychiatria et Neurologia Japonica
113: 873-879, 2011
<Keywords:bipolar depression, evidence, quetiapine, Lithium>