Depressive episodes are significant in bipolar illness since patients can spend up to one-third of their lives in depression. Although the treatment of bipolar depression remains an understudied area, new data from randomized, controlled trials and naturalistic studies expanded the range of treatments avaliable. The main aim in the treatment of bipolar depression is the prevention of the patient switching to mania and cycle acceleration, and antidepressant therapy may be contraindicated because of the risk for switching. Guidelines for the acute treatment of the bipolar depression emphasize treatment with a mood stabilizer, of which lithium has been the most thoroughly studied in randomized, controlled trials in acute bipolar depression. Lamotrigine had found significant ellicacy in recent studies as well and got FDA approval for its effect on preventing new episodes.
Key words: Bipolar depression, cycle acceleration, manic switch, mood stabilizers, novel antipsychotics, prophylactic treatment
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