Pharmacotherapy of bipolar disorder: current status and emerging options

  title={Pharmacotherapy of bipolar disorder: current status and emerging options},
  author={Emily Kl Sandlin and Yong-lin Gao and Rif S El-Mallakh},
SUMMARY In the treatment of bipolar depression, the debate regarding the utility and safety of antidepressants continues. There are several agents that are available for the treatment of bipolar depression, including US FDA-approved agents such as quetiapine and lurasidone, and non-FDA-approved agents such as lamotrigine, pramipexole, modafinil and armodafinil, and ketamine. Efficacy studies for the use of antidepressants are lacking, but safety concerns are quite real with an increased risk of… 

Lurasidone: A Review of Its Use in Adult Patients with Bipolar I Depression

Lurasidone offers a valuable addition to the therapies available for adult patients with bipolar I depression, either as monotherapy or as an adjunct to lithium or valproate.



Antipsychotic medications in the treatment of bipolar disorder.

This paper will critically review available randomized clinical trials utilizing antipsychotic agents in bipolar disorder and suggest that both first and second generation agents appear to have a beneficial effect.

Naturalistic Long-term Use of Methylphenidate in Bipolar Disorder

Methylphenidate seems to be safe in the naturalistic setting and controlled studies are needed to confirm its efficacy and safety in bipolar depression, especially in children with comorbid bipolar and attention-deficit disorder.

Adjunctive stimulant use in patients with bipolar disorder: treatment of residual depression and sedation.

The present case series suggests that adjunctive stimulants may be a reasonable therapeutic option for treating residual depression and medication-induced sedation in some patients with bipolar disorder.

Novel uses for risperidone: focus on depressive, anxiety and behavioral disorders

A review of the literature provides varying levels of evidence supporting risperidone's use in a range of depressive and anxiety disorders, and in special populations, including children and the elderly, with recommendations and suggestions for its use.

Bipolar depression

The literature review presented here focuses on the clinical trials that led to the Food and Drug Administration-approval of these second generation antipsychotics in the treatment of bipolar depression.

Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies.

The guidelines suggest that although pharmacotherapy forms the cornerstone of management, utilization of adjunctive psychosocial treatments and incorporation of chronic disease management model involving a healthcare team are required in providing optimal management for patients with bipolar disorder.

Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone.

Post hoc secondary analyses suggest that lamotrigine may be superior to inositol and risperidone in improving treatment-resistant bipolar depression.

Efficacy and safety of venlafaxine in the treatment of bipolar II major depressive episode.

  • J. Amsterdam
  • Psychology, Medicine
    Journal of clinical psychopharmacology
  • 1998
Preliminary findings suggest that short-term, 6-week venlafaxine treatment may be a safe and effective antidepressant monotherapy for BP II major depression.

Cariprazine in Bipolar Disorder: Clinical Efficacy, Tolerability, and Place in Therapy

  • L. Citrome
  • Psychology, Medicine
    Advances in Therapy
  • 2013
The most commonly encountered adverse events in the mania trials were extrapyramidal disorder, akathisia, insomnia, vomiting, restlessness, sedation, vision blurred, and pain in extremity; the differences in incidence versus placebo for these events were generally small.

Effectiveness of adjunctive antidepressant treatment for bipolar depression.

The use of adjunctive, standard antidepressant medication, as compared with the use of mood stabilizers, was not associated with increased efficacy or with increased risk of treatment-emergent affective switch.