The Role of Atypical Antipsychotic Therapy for Patients with Treatment- Resistant Bipolar Depression

Anish Shah

doi:10.4172/psychiatry.1000150

Abstract

Physicians treating patients with bipolar depression have a unique challenge when considering drug therapy. Historically, patients with bipolar depression have been treated with SSRIs or other medications commonly utilized with patients presenting with non-bipolar depression. Indeed, many of these medications are not ideal for patients suffering from bipolar depression. Recently, a class of second-generation atypical antipsychotics has emerged as an exciting new avenue for the treatment of bipolar depressive episodes. While these medications have received a wealth of empirical support for treating treatment-resistant unipolar depression, less is known about the efficacy of these medications in treating bipolar depression. Early evidence is promising, though additional trials may be warranted to more clearly delineate the role of second-generation atypical antipsychotics in treating bipolar depressive episodes. This article discusses the second-generation atypical antipsychotics that have received empirical support for use in treating depressive symptoms in patients with bipolar depression. Current FDA approvals for usage are reviewed and avenues for future work are proposed.

Highlights

The annual prevalence estimates for bipolar disorder around the world range from 0.0% in some countries to 0.6%, and are around 0.3% for bipolar II disorder [1]
Bipolar depression is of particular concern when considering drug therapy, as there is some risk for inducing mania or rapid cycling
Traditional medications utilized with major depression are not ideal for use with patients suffering from bipolar disorder

Summary

Introduction

The annual prevalence estimates for bipolar disorder around the world range from 0.0% in some countries to 0.6%, and are around 0.3% for bipolar II disorder [1]. Findings from previous studies have suggested that individuals recently diagnosed with bipolar disorder spend approximately three times more time in a depressive episode compared to both mania and hypomania [9]. This risk appears to be relevant for the use of SNRIs. Evidence from clinical trials using these medications have indicated that a generous portion of bipolar disorder patients can expect a degree of improvement in their depressive symptoms from these treatments when compared to a placebocontrolled group (i.e., approximately 45% achieved remission status) [13].

Results

Conclusion