Antidepressants in bipolar disorder: 7 myths and realities
Current Psychiatry. 2010 May;09(05):41-49
May 1, 2010|Current Psychiatry
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Dispelling misconceptions leads to rationale-based steps for treating bipolar depression
Step 4: Consider novel strategies. In the absence of a response to the strategy outlined above—particularly among poor candidates for continued antidepressant therapy—other novel strategies have support from at least 1 randomized controlled trial, including pramipexole,32,33 modafinil,34 riluzole,35 and n-acetyl cysteine.36 Other interventions worth considering include:
- adjunctive thyroid hormone
- cognitive therapy
- light therapy (if a seasonal component is evident)
- electroconvulsive therapy.
Related resources
- Goldberg JF. Treating depression in bipolar disorder. https://thedoctorschannel.com/video/3077.html.
- Goldberg JF. Pharmacologic treatment of acute mania.https://thedoctorschannel.com/video/3032.html.
Drug brand names
- Atomoxetine • Strattera
- Bupropion • Wellbutrin
- Carbamazepine • Tegretol, Equetro
- Citalopram • Celexa
- Desipramine • Norpramin
- Desvenlafaxine • Pristiq
- Divalproex • Depakote, Depakene
- Duloxetine • Cymbalta
- Escitalopram • Lexapro
- Fluoxetine • Prozac
- Fluvoxamine • Luvox
- Imipramine • Tofranil
- Isocarboxazid • Marplan
- Lamotrigine • Lamictal
- Lithium • Lithobid, Eskalith
- Milnacipran • Ixel, Savella
- Mirtazapine • Remeron
- Moclobemide • Aurorix, Manerix
- Modafinil • Provigil
- Nefazodone • Serzone
- Olanzapine • Zyprexa
- Olanzapine-fluoxetine • Symbyax
- Paroxetine • Paxil
- Phenelzine • Nardil
- Pramipexole • Mirapex
- Quetiapine • Seroquel
- Riluzole • Rilutek
- Selegiline transdermal • EMSAM
- Sertraline • Zoloft
- Tranylcypromine • Parnate
- Venlafaxine • Effexor
Disclosures
Dr. Goldberg is a consultant to Eli Lilly and Company and a speaker for AstraZeneca, Eli Lilly and Company, GlaxoSmithKline, Merck, and Pfizer Inc., and has received speaking honoraria from Janssen-Cilag.
