Harvard Mental Health Letter

In Brief: Treatment for bipolar depression: New studies

In Brief

Treatment for bipolar depression: New studies

Depression in bipolar disorder is a condition that lasts longer than mania and causes more suffering and disability. Because the symptoms of bipolar depression often combine despair with agitation and impulsiveness, it is an important cause of suicide. It also raises the risk of death from cardiovascular disease and other causes.

Bipolar depression is often difficult to diagnose, and even when correctly diagnosed, difficult to treat. In studies published in 2007, researchers have learned more about the limitations of drug treatments while finding evidence for the effectiveness of intensive psychotherapy.

Common drug treatments for acute bipolar depression are lithium and the anticonvulsant lamotrigine (Lamictal). To prevent depression from returning after recovery, clinicians may continue to prescribe these drugs and add others, including the antipsychotic drugs olanzapine (Zyprexa) and quetiapine (Seroquel). When depression does not respond to medications, electroconvulsive therapy (ECT) is an alternative.

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