Therapy of Bipolar Depression

Overview

The authors bring attention to the diagnosis of bipolar depression, which is most often misdiagnosedas unipolar depression with all the consequences. With acute treatment in patients already treatedwith mood stabilizers we should optimize levels and doses; in previously untreated patients we preferlithium and lamotrigine. In the case of unsuccessful monotherapy an antidepressant is usually added.In spite of consensus of many algorithms the bipolar depression is not often treated with stabilizers.The situation at the Psychiatric Department in Brno was mapped. In the retrospective analysistotally 33 patients hospitalized during 2 years (November 2001–2003) with bipolar depression wereidentifi ed. At admission 24% were diagnosed as affected by unipolar depression, 12% came to thehospitalization after suicidal attempt and 12% were not treated before admission, whereas 51% camewith mood stabilizers. More patients were dismissed with mood stabilizers (51% vs 81%, p=0.01).

Key words:
bipolar depression, unipolar depression, mood stabilizers, antidepressants