Current landscape, unmet needs, and future directions for treatment of bipolar depression

Mark A. Frye*, Miguel L. Prieto, William V. Bobo, Simon Kung, Marin Veldic, Renato D. Alarcon, Katherine M. Moore, Doo Sup Choi, Joanna M. Biernacka, Susannah J. Tye

*Autor correspondiente de este trabajo

Resultado de la investigación: Contribución a una revistaArtículo de revisiónrevisión exhaustiva

31 Citas (Scopus)

Resumen

Background
Depression is the predominant pole of illness disability in bipolar disorder and, compared with acute mania, has less systematic research guiding treatment development. The aim of this review is to present the therapeutic options currently available for managing bipolar depression and to highlight areas of unmet need and future research.

Methods
Literature search of PubMed, PsycINFO, and Cochrane databases and bibliographies from 2000 to August 2013 for treatments that have regulatory approval for bipolar depression or early controlled preliminary data on efficacy.

Results
Treatment options for bipolar depression have increased over the last decade, most notably with regulatory approval for olanzapine/fluoxetine combination, quetiapine, and lurasidone. Conventional mood stabilizers lamotrigine and divalproex have meta-analyses suggesting acute antidepressant response. Manual-based psychotherapies also appear to be effective in treating bipolar depression. The therapeutic utility of unimodal antidepressants, as a class, for the treatment of patients with bipolar depression, as a group, remains to be confirmed. There is a substantially unmet need to develop new interventions that are efficacious, effective, and have low side effect burden.

Limitations
Additional compounds are currently being developed that may ultimately be applicable to the treatment of bipolar depression and early open-trial data encourage further studies, but both of these topics are beyond the scope of this review.

Conclusion
Future registrational trials will need to establish initial efficacy, but increasing interest for personalized or individualized medicine will encourage further studies on individual predictors or biomarkers of response.
Idioma originalInglés
Páginas (desde-hasta)S17-S23
PublicaciónJournal of Affective Disorders
Volumen169
N.ºS1
DOI
EstadoPublicada - 1 dic. 2014

Nota bibliográfica

Publisher Copyright:
© 2014 Elsevier B.V. All rights reserved.

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