They first discussed problems in bipolar depression treatment. They noted the
fact that at least until recently, this diagnosis has been overlooked in favor
of mania in the treatment of bipolar disorder. In many areas of the world, it is
either misdiagnosed as unipolar depression or under diagnosed in general.
Regarding clinical evidence, there has been very little up until recently, with
most clinical investigation focusing on the treatment of mania.
As a result, clinicians used what they knew would work symptomatically,
namely antidepressants. Even though currently there are treatments that have
been studied and approved specifically for depression, bipolar depression
treatment remain the most common treatment, despite of the fact that there are
consistent data that antidepressants can induce mania or rapid cycling.
In addition, there is evidence that clinical depression treatment is less
effective in preventing depressive symptoms in bipolar disorder than an bipolar
depression treatment-mood stabilizer combination. As a result, many treatment/
bipolar depression treatment
guidelines
The group noted, however, that clinical depression treatment is frequently used
anyway and speculated this was due to a number of factors. They cited 4 myths
about bipolar treatment that have either been disproved or are not supported by
current evidence:
(1) bipolar disorder is not a lifelong illness and episodes only need to be
treated acutely;
(2) antidepressants should only be augmented with mood stabilizers if manic
symptoms appear;
(3) the addition of an antidepressant to a mood stabilizer has a more rapid
onset of action; and
(4) recent episode frequency has no effect on bipolar depression treatment
selection. In addition to this mythology, they also noted that patients tend to
prefer clinical depression treatment, particularly if they enjoy their periods
of hypomania, so they may put pressure on their physicians. Despite this, the
group noted hope-generating trends in practice method, particularly the use of
second-generation antipsychotics as monotherapy for bipolar depression.
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