Atypical Antipsychotics in Bipolar Depression: Applying Emerging Evidence to Clinical Practice

Abstract

<P>Bipolar I disorder is an omnipresent illness affecting around 1% of the population. More pressing is the increasing recognition that this figure grows much higher when combined with the prevalence for bipolar II disorder (3.7%) and perhaps reaches greater than 6% when an expanded spectrum of bipolar disorder is considered. The course of illness followed by many patients with bipolar disorder often is chronic, marked by predominance of depressive episodes or symptoms, and significant disability particularly due to depressive morbidity. Additionally, suicidality is more common in bipolar depression (BD) than in mania.</P> <H4>ABOUT THE AUTHORS</H4> <P>Dr. Muzina is vice chair for research and education, Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine at Case, Cleveland, OH. Dr. Gajwani is clinical director, Mood Disorders Program, University Hospitals of Cleveland Clinic Health System, and assistant professor of psychiatry, Case Western Reserve University School of Medicine, Cleveland. Dr. Kemp is research fellow, Mood Disorders Program, University Hospitals of Cleveland Clinic Health System. Dr. Gao is assistant professor of psychiatry, Case Western Reserve University School of Medicine. Dr. Calabrese is director, Mood Disorders Program, University Hospitals of Cleveland Clinic Health System; director, Bipolar Disorders Research Center, University Hospitals Case Medical Center; and professor of psychiatry, Case Western Reserve University School of Medicine. </P> <P>Address reprint requests to: David J. Muzina, MD, Cleveland Clinic Department of Psychiatry and Psychology, 9500 Euclid Ave, P57, Cleveland, OH 44195; or e-mail <a href="mailto:muzinad@ccf.org">muzinad@ccf.org</a>. </P> <P>Dr. Muzina disclosed relevant financial relationships with Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Pfizer, and Repligen. Dr. Gajwani disclosed relevant financial relationships with Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Cyberonics, Forest Laboratories, and Pfizer. Dr. Kemp disclosed relevant financial relationships with Abbott Laboratories and Bristol-Myers Squibb. Dr. Gao disclosed a relevant financial relationship with AstraZeneca. Dr. Calabrese disclosed relevant financial relationships with Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Ciba-Giegy, Eli Lilly, GlaxoSmithKline, Janssen, Novartis, Parke-Davis, Sandoz Pharmaceuticals, Shire, SmithKline Beecham, TAP, Teva, UCB Pharma, and Wyeth Ayerst.</P>