• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Blogs » The Carlat Psychiatry Podcast » Can therapy work on its own in bipolar II?

The Carlat Psychiatry Podcast
The Carlat Psychiatry Podcast RSS FeedRSS

Clear, engaging, and practical updates on clinical psychiatry.
Earn CME for listening to the podcast with a Podcast CME Subscription.
Listen for free here or using Apple Podcasts, Android, or Stitcher.

Can therapy work on its own in bipolar II?

July 2, 2020


This week we’re podcasting from the International Society for Bipolar Disorders 2020 conference, where we’ve been scouring the virtual halls for all that is practical and newsworthy. The yield is high so tune in for a new episode every day. Today, unpublished findings on the first solo psychotherapy study in bipolar II.

Published On: 7/2/2019

Duration: 4 minutes, 15 seconds

Transcript:

This week we’re podcasting from the International Society for Bipolar Disorders 2020 conference, where we’ve been scouring the virtual halls for all that is practical and newsworthy. The yield is high so tune in for a new episode every day. Today, unpublished findings on the first solo psychotherapy study in bipolar II.

Welcome to the Carlat Psychiatry Podcast, keeping psychiatry honest since 2003. I’m Chris Aiken, the editor in chief of the Carlat Report. And I’m Kellie Newsome, a psychiatric NP and a dedicated reader of every issue.

In 2018 Holly Swartz and colleagues published a first-in-class trial: They bravely tested whether psychotherapy alone could treat bipolar II depression, without medication. The small study of 77 patients randomized patients to interpersonal social rhythm therapy or IPSRT + quetiapine. The quetiapine group got better faster, but both groups had the same recovery rates at the end of the 5 months. Though preliminary, the results suggest that IPSRT may be a feasible therapy on its own for bipolar II depression. 

The study also yielded some interesting secondary outcomes. Patients were 4.5 times more likely to get better if they were randomized to the treatment they preferred to begin with – medication or therapy.  Also, the therapy was not without biological effects. IPSRT actually improved markers of inflammation, while quetiapine did not.

At the 2020 conference Dr. Schwartz’s group presented more secondary outcomes from this study. Reanalyzing the data, they found that adding quetiapine did not change the survival curves of symptomatic, syndromal, or functional recovery, so no matter how they defined improvement the result was the same.

Importantly, this study was in bipolar II, not bipolar I, and it illustrates the problem with conflating the two disorders. A study of therapy alone for Bipolar I would be unlikely to pass the ethics committee because the risk of mania would be high, and the consequences of mania are dire. Bipolar II is not prone to mania; it’s an illness of depression, and therapy is already well known to treat depression without medication.

To learn more about social rhythm therapy, check out our June 8 2020 podcast. 

Do you like your Carlat Podcast daily? Are we overwhelming you or should we keep up the pace? Let us know by leaving a review in your podcast store. 

Tomorrow we’ll bring you an unpublished finding from the Mayo Clinic that challenges conventional wisdom about lithium’s toxicity on the kidneys. We’ll have more updates in our print issue, including unpublished results on a new medication for bipolar depression and a full review of the modafinils in bipolar disorder. 

Got feedback? Take the podcast survey.
Introducing Carlat Total Access Subscriptions

Complete access to every article you search on the website.

Shop for Total Access
Free Psychiatry Updates
The latest unbiased psychiatric information sent to your inbox.
Specify Your Interests
Featured Book
  • PB4e_Cover2.png

    Psychiatry Practice Boosters, Fourth Edition (2023)

    Teaches you the key points of 63 of the most clinically relevant studies in psychiatry.
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • shutterstock_2369359177.jpg
    General Psychiatry

    Bipolar Upgrade 7: Social Rhythm Therapy

    Social Rhythm Therapy helps patients regulate their circadian rhythm. It treats bipolar disorder,
    and here we show how to weave it in with medication therapy.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report
  • The Carlat Psychotherapy Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.