Bipolar Depression

Research Update

Maintenance Pharmacotherapy of Bipolar Disorder: How Long Is Long Enough?

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Lithium | Medication adherence | Mood Stabilizers | retention

Review of: Kishi T et al, Psychol Med 2020 Oct 13:1–9; PMID: 33046156 Type of study: Meta-analysis of double-blind, randomized placebo-controlled trials Bipolar disorder is a lifelong illness whose treatment is an ongoing challenge, complicated not least by difficulties in treatment adherence. What do we know and what can we tell our patients about

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Research Update

Antidepressants Harm Some With Bipolar Depression

Topics: Antidepressants | Bipolar Depression | Bipolar Disorder

REVIEW OF: Ghaemi SN et al, J Clin Psychiatry 2021;82(1):19m13136 Study TYPE: Randomized, double-blind, placebo-controlled trial Antidepressants are controversial in bipolar depression, in part because we don’t have enough well-designed studies to clarify their role. The most rigorous trials have come up negative, and many of the positive ones s

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Clinical Update

How to Use Lamotrigine

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Borderline Personality Disorder | BPD | Hypomania | Lamictal | Lamotrigine | Medication | Mood Stabilizers | OCD | Pharmacology | Psychopharmacology

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

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Research Update

Mood Stabilizers: What You Don’t Know Can Hurt Them

Topics: Antipsychotics | Aripiprazole | Asenapine | Bipolar Depression | Bipolar Disorder | Bipolar II | Cariprazine | Lithium | Lurasidone | Mania | Medication adherence | Mood Stabilizers | olanzapine | Oxcarbazepine | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips | Quetiapine | Research | Research Update | Risperidone | safety | Saphris | Side Effects

Review of: Bai Y et al, J Clin Psychopharmacol 2020;40(2):167–179 STUDY TYPE: Combined meta-analysis and literature review of placebo-controlled trials Medication adherence is an ongoing struggle in bipolar disorder, and it’s compounded by the fact that our patients often don’t advertise their ­non-adherence. While numbers vary, reviews general

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Research Update

A New Antipsychotic for Bipolar Depression

Topics: Antipsychotics | Bipolar Depression | Bipolar Disorder | Bipolar II | Caplyta | Lumateperone | Research Update

Lumateperone (Caplyta) just hit the pharmacy shelves with FDA approval in schizophrenia (see TCPR March 2020), and its manufacturer is pursuing further approval for bipolar depression. So far they’ve completed two phase III trials—one negative and one positive—and the positive one was presented in poster form by Suresh Durgam and colleagues at the

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News of Note

A New Treatment for Bipolar Depression

Topics: Antipsychotics | Atypical Antipsychotics | Bipolar Depression | Bipolar Disorder | Depression | News of Note | Pharmacology | Psychopharmacology

On May 28, 2019, cariprazine (Vraylar) became the fourth atypical antipsychotic to receive FDA approval for bipolar depression. The approval was based on two randomized controlled trials involving 1,051 patients and lasting 6–8 weeks. These studies grouped patients into fixed doses from 0.75–3 mg/day. The sweet spot seems to be 1.5 mg/day, which was

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