A Study of Pharmacotherapy for Bipolar Depression

Chae, Su Kwang; Yoon, Doh Joon; Bahn, Keon Ho; Kim, Jong Woo

Abstract

OBJECT: Although there is extensive research. on treatment of acute unipolar depression, few studies examined the treatment of acute bipolar depression. This preliminary study was designed to suggest clinical guideline for treatment of bipolar depression through comparing the pharmacological treatment of bipolar depression with that of unipolar depression. METHOD: We studied 19 patients with bipolar depression and 38 patients with unipolar depression, who were admitted to Kyung Hee University Medical Crater from January 1990 to December 1997. The pattern of treatment and the response to treatment of bipolar depression were investigated compared with unipolar depression.
RESULTS
The percentage of prescription in bipolar depression was as follows in order : combination of mood stabilizer and an antidepressant 52.6%, mood stabilizers 15.8%, ECT 15.8%, TCAs 5.3%, SSRIs 5.3%, RIMA 5.3%. In unipolar depression : TCAs 47.4%, SSRIs 28.9%, combination of mood stabilizer and an antidepressant 10.5%, others 13.2%. There was no significant difference in response to treatment in bipolar depression and unipolar depression.
CONCLUSIONS
These results suggest a mood stabilizer and an antidepressant together or a mood stabilizer alone would be first line in bipolar depression. Among the antidepressants, bupropion, RIMA and SSRls is more recommended in that order rather than TCAs in consideration of the risk of switching into mania.