Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T23:49:05.967Z Has data issue: false hasContentIssue false
  • English
  • Français

Bipolar depression: Diagnostic and treatment considerations

Published online by Cambridge University Press:  25 October 2006

MICHAEL E. THASE
MICHAEL E. THASE
Affiliation:
University of Pittsburgh Medical Center
Get access Rights & Permissions [Opens in a new window]

Abstract

Bipolar affective disorder is a recurrent, disabling, and potentially lethal illness that typically begins early in life. Although the disorder is defined by the manic and hypomanic episodes, for most people the depression episodes are the more virulent aspect of the illness. Specifically, the depressive episodes are more numerous, last longer, and are more difficult to treat than the manias, and depression is the principal cause of the illness's increased mortality due to suicide. For people with early-onset depression, predictors of subsequent bipolarity include a family history, psychotic features, and reverse neurovegetative features. Initial episodes of depression are commonly misdiagnosed, which often delays initiation of appropriate therapy and increases the likelihood of treatment with antidepressants alone. Unfortunately, the correct diagnosis is often not made until there has been a treatment–emergent affective switch. There are no treatments specifically approved for bipolar disorder in youth and, among antidepressants, only fluoxetine has received approved. When bipolarity is suspected, treatment with mood stabilizers, both conventional (i.e., lithium, valproate, and carbamazapine) and more recently classified (lamotrigine) and atypical antipsychotics should be prioritized. When antidepressants are indicated in combination with mood stabilizers, first choice options include bupropion and the selective serotonin reuptake inhibitors. Studies of adults indicate that several forms of focused psychotherapy may improve longer term outcomes.

Type
Research Article
Information
Development and Psychopathology , Volume 18 , Issue 4 , December 2006 , pp. 1213 - 1230
Copyright
© 2006 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Akiskal, H. S. (1995). Developmental pathways to bipolarity: Are juvenile-onset depression pre-bipolar? Journal of the American Academy of Child and Adolescent Psychiatry, 34, 754–763.Google Scholar
Akiskal, H. S. (2005). Searching for behavioral indicators of bipolar II in patients presenting with major depressive episodes: The “red sign,” the “rule of three” and other biographic signs of temperamental extravagance, activation and hypomania. Journal of Affective Disorders, 84, 279–290.CrossRefGoogle Scholar
Akiskal, H. S., & Benazzi, F. (2005). Atypical depression: A variant of bipolar II or a bridge between unipolar and bipolar II? Journal of Affective Disorders, 84, 209–217.Google Scholar
Akiskal, H. S., Benazzi, F., Perugi, G., & Rihmer, Z. (2005). Agitated “unipolar” depression re-conceptualized as a depressive mixed state: Implications for the antidepressant-suicide controversy. Journal of Affective Disorders, 85, 245–258.CrossRefGoogle Scholar
Akiskal, H. S., Hantouche, E. G., Allilaire, J. F., Sechter, D., Bourgeois, M. L., Azorin, J. M., et al. (2003). Validating antidepressant-associated hypomania (bipolar III): A systematic comparison with spontaneous hypomania (bipolar II). Journal of Affective Disorders, 73, 65–74.CrossRefGoogle Scholar
Akiskal, H. S., Maser, J. D., Zeller, P. J., Endicott, J., Coryell, W., Keller, M., et al. (1995). Switching from “unipolar” to bipolar II. An 11-year prospective study of clinical and temperamental predictors in 559 patients. Archives of General Psychiatry, 52, 114–123.CrossRefGoogle Scholar
Altshuler, L., Suppes, T., Black, D., Nolen, W. A., Keck, P. E., Jr., Frye, M. A., et al. (2003). Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up. American Journal of Psychiatry, 160, 1252–1262.CrossRefGoogle Scholar
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
American Psychiatric Association. (2002). Practice guideline for the treatment of patients with bipolar disorder (revision). American Journal of Psychiatry, 159, 3–50.Google Scholar
Amsterdam, J. D. (2003). A double-blind, placebo-controlled trial of the safety and efficacy of selegiline transdermal system without dietary restrictions in patients with major depressive disorder. Journal of Clinical Psychiatry, 64, 208–214.CrossRefGoogle Scholar
Amsterdam, J. D., & Brunswick, D. J. (2003). Antidepressant monotherapy fro bipolar type II major depression. Bipolar Disorders, 5, 388–395.CrossRefGoogle Scholar
Amsterdam, J. D., & Garcia-Espana, F. (2000). Venlafaxine monotherapy in women with bipolar II and unipolar major depression. Journal of Affective Disorders, 59, 225–229.CrossRefGoogle Scholar
Amsterdam, J. D., Shults, J., Brunswick, D. J., & Hundert, M. (2004). Short-term fluoxetine monotherapy for bipolar type II or bipolar NOS major depression—Low manic switch rate. Bipolar Disorders, 6, 75–81.CrossRefGoogle Scholar
Angst, J. (2004). Bipolar disorder—A seriously underestimated health burdern. European Archives of Psychiatric and Clinical Neuroscience, 254, 59–60.CrossRefGoogle Scholar
Angst, J., & Stabl, M. (1992). Efficacy of moclobemide in different patient groups: A meta-analysis of studies. Psychopharmacology (Berlin), 106, S109–S113.CrossRefGoogle Scholar
Baldessarini, R. J., Tondo, L., & Hennen, J. (2003). Lithium treatment and suicide risk in major affective disorders: Update and new findings. Journal of Clinical Psychiatry, 64, 44–52.Google Scholar
Beasley, C. M., Masica, D. N., Heiligenstein, J. H., Wheadon, D. E., & Zerbe, R. L. (1993). Possible monoamine oxidase inhibitor–serotonin reuptake inhibitor interaction: Fluoxetine clinical data and preclinical findings. Journal of Clinical Psychopharmacology, 13, 312–320.Google Scholar
Blanco, C., Laje, G., Olfson, M., Marcus, S. C., & Pincus, H. A. (2002). Trends in the treatment of bipolar disorder by outpatient psychiatrists. American Journal of Psychiatry, 159, 1005–1010.CrossRefGoogle Scholar
Bowden, C. L., Asnis, G. M., Ginsberg, L. D., Bentley, B., Leadbetter, R., & White, R. (2004). Safety and tolerability of lamotrigine for bipolar disorder. Drug Safety, 27, 173–184.CrossRefGoogle Scholar
Bowden, C. L., Calabrese, J. R., Sachs, G., Yatham, L. N., Asghar, S. A., Hompland, M., et al. (2003). A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Archives of General Psychiatry, 60, 392–400.CrossRefGoogle Scholar
Buckley, N. A., & Faunce, T. A. (2003). “Atypical” antidepressants in overdose: Clinical considerations with respect to safety. Drug Safety, 26, 539–551.CrossRefGoogle Scholar
Calabrese, J., Sachs, G., & Hirschfeld, R. M. A. (2005). Efficacy and safety of lamotrigine in acute bipolar depression: Findings from three completed studies. Presented at the 45th Annual Meeting of the New Clinical Drug Evaluation Unit, Boca Raton, FL, June 6–9, 2005.
Calabrese, J. R., Bowden, C. L., Sachs, G., Yatham, L. N., Behnke, K., Mehtonen, O.-P., et al. (2003). A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. Journal of Clinical Psychiatry, 64, 1013–1024.CrossRefGoogle Scholar
Calabrese, J. R., Bowden, C. L., Sachs, G. S., Ascher, J. A., Monaghan, E., Rudd, G. D., et al. (1999). A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Journal of Clinical Psychiatry, 60, 79–88.CrossRefGoogle Scholar
Calabrese, J. R., Keck, P. E., MacFadden, W., Minkwitz, M., Ketter, T. A., Weisler, R. H., et al. (2005). A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. American Journal of Psychiatry, 162, 1351–1360.CrossRefGoogle Scholar
Calabrese, J. R., Sullivan, J. R., Bowden, C. L., Suppes, T., Goldberg, J. F., Sachs, G. S., et al. (2002). Rash in multicenter trials of lamotrigine in mood disorders: Clinical relevance and management. Journal of Clinical Psychiatry, 63, 1012–1019.CrossRefGoogle Scholar
Calabrese, J. R., Suppes, T., Bowden, C. L., Sachs, G. S., Swann, A. C., McElroy, S. L., et al. (2000). A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Journal of Clinical Psychiatry, 61, 841–850.CrossRefGoogle Scholar
Cheeta, S., Schifano, F., Oyefeso, A., Webb, L., & Ghodse, A. H. (2004). Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998–2000. British Journal of Psychiatry, 184, 41–47.CrossRefGoogle Scholar
Colom, F., & Vieta, E. (2004). A perspective on the use of psychoeducation, cognitive-behavioral therapy and interpersonal therapy for bipolar patients. Bipolar Disorders, 6, 480–486.CrossRefGoogle Scholar
Davis, L. L., Bartolucci, A., & Petty, F. (2005). Divalproex in the treatment of bipolar depression: A placebo-controlled study. Journal of Affective Disorders, 85, 259–266.CrossRefGoogle Scholar
DelBello, M. P., Schwiers, M. L., Rosenberg, H. L., & Strakowski, S. M. (2002). A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1216–1223.CrossRefGoogle Scholar
Dunner, D. L., & Fieve, R. R. (1974). Clinical factors in lithium carbonate prophylaxis failure. Archives of General Psychiatry, 30, 229–233.CrossRefGoogle Scholar
Findling, R. L., Youngstrom, E. A., McNamara, N. K., Stansbrey, R. J., Demeter, C. A., Bedoya, D., et al. (2005). Early symptoms of mania and the role of parental risk. Bipolar Disorders, 7, 623–634.CrossRefGoogle Scholar
Frank, E., Kupfer, D. J., Ehlers, C. L., Monk, T. H., Cornes, C., Carter, S., et al. (1994). Interpersonal and social rhythm therapy for bipolar disorder: Integrating interpersonal and behavioral approaches. The Behavior Therapist, 17, 143–149.Google Scholar
Frank, E., Kupfer, D. J., Thase, M. E., Mallinger, A. G., Swartz, H. A., Fagiolini, A. M., et al. (2005). Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry, 62, 996–1004.CrossRefGoogle Scholar
Frye, M. A., Ketter, T. A., Kimbrell, T. A., Dunn, R. T., Speer, A. M., Osuch, E. A., et al. (2000). A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. Journal of Clinical Psychopharmacology, 20, 607–614.CrossRefGoogle Scholar
Geddes, J. R., Burgess, S., Hawton, K., Jamison, K., & Goodwin, G. M. (2004). Long-term lithium therapy for bipolar disorder: Systematic review and meta-analysis of randomized controlled trialls. American Journal of Psychiatry, 161, 217–222.CrossRefGoogle Scholar
Ghaemi, S. N., Boiman, E. E., & Goodwin, F. K. (2000). Diagnosing bipolar disorder and the effect of antidepressants: A naturalistic study. Journal of Clinical Psychiatry, 61, 804–808.CrossRefGoogle Scholar
Gijsman, H. J., Geddes, J. R., Rendell, J. M., Nolen, W. A., & Goodwin, G. M. (2004). Antidepressants for bipolar depression: A systematic review of randomized, controlled trials. American Journal of Psychiatry, 161, 1537–1547.CrossRefGoogle Scholar
Goodwin, F. K., Fireman, B., Simon, G. E., Hunkeler, E. M., Lee, J., & Revicki, D. (2003). Suicide risk in bipolar disorder during treatment with lithium and divalproex. Journal of the American Medical Association, 290, 1467–1473.CrossRefGoogle Scholar
Goodwin, G. M., Bowden, C. L., Calabrese, J. R., Grunze, H., Kasper, S., White, R., et al. (2004). A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder. Journal of Clinical Psychiatry, 65, 432–441.CrossRefGoogle Scholar
Gyulai, L., Bowden, C. L., McElroy, S. L., Calabrese, J. R., Petty, F., Swann, A. C., et al. (2003). Maintenance efficacy of divalproex in the prevention of bipolar depression. Neuropsychopharmacology, 28, 1374–1382.CrossRefGoogle Scholar
Himmelhoch, J. M., Thase, M. E., Mallinger, A. G., & Houck, P. (1991). Tranylcypromine versus imipramine in anergic bipolar depression. American Journal of Psychiatry, 148, 910–916.Google Scholar
Hirschfeld, R. M. A., Calabrese, J. R., Weissman, M. M., Reed, M., Davies, M. A., Frye, M. A., et al. (2003). Screening for bipolar disorder in the community. Journal of Clinical Psychiatry, 64, 53–59.CrossRefGoogle Scholar
Hirschfeld, R. M. A., Lewis, L., & Vornik, L. A. (2003). Perceptions and impact of bipolar disorder: How far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 Survey of Individuals with Bipolar Disorder. Journal of Clinical Psychiatry, 64, 161–174.CrossRefGoogle Scholar
Hirschfeld, R. M. A., Williams, J. B. W., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., Jr., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: The mood disorder questionnaire. American Journal of Psychiatry, 157, 1873–1875.CrossRefGoogle Scholar
Hlastala, S. A., Frank, E., Mallinger, A. G., Thase, M. E., Ritenour, A. M., & Kupfer, D. J. (1997). Bipolar depression: An underestimated treatment challenge. Depression and Anxiety, 5, 73–83.3.0.CO;2-6>CrossRefGoogle Scholar
Hunkeler, E. M., Fireman, B., Lee, J., Diamond, R., Hamilton, J., He, C. X., et al. (2005). Trends in use of antidepressants, lithium, and anticonvulsants in Kaiser Permanente-insured youths, 1994–2003. Journal of Child and Adolescent Psychopharmacology, 15, 26–37.CrossRefGoogle Scholar
Joffe, H., Cohen, L. S., Suppes, T., McLaughlin, W. L., Lavori, P., Adams, J. M., et al. (2006). Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder. Biologic Psychiatry, 59, 1078–1086.CrossRefGoogle Scholar
Joffe, H., Hall, J. E., Cohen, L. S., Taylor, A. E., & Baldessarini, R. J. (2003). A putative relationship between valproic acid and polycystic ovarian syndrome: Implications for treatment of women with seizure and bipolar disorders. Harvard Review of Psychiatry, 11, 99–108.Google Scholar
Joffe, R. T., MacQueen, G. M., Marriott, M., Robb, J., Begin, H., & Young, L. T. (2002). Induction of mania and cycle acceleration in bipolar disorder: Effect of different classes of antidepressant. Acta Psychiatrica Scandinavica, 105, 427–430.CrossRefGoogle Scholar
Judd, L. L., & Akiskal, H. S. (2003). The prevalence and disability of bipolar spectrum disorders in the US population: Re-analysis of the ECA database taking into account subthreshold cases. Journal of Affective Disorders, 73, 123–131.CrossRefGoogle Scholar
Judd, L. L., Akiskal, H. S., Schettler, P. J., Coryell, W., Endicott, J., Maser, J. D., et al. (2003). A prospective investigation of the natural history of the long-term weeekly symptomatic status of bipolar II disorders. Archives of General Psychiatry, 60, 261–269.CrossRefGoogle Scholar
Judd, L. L., Akiskal, H. S., Schettler, P. J., Endicott, J., Maser, J., Solomon, D. A., et al. (2002). The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry, 59, 530–537.CrossRefGoogle Scholar
Keck, P. E., Perlis, R. H., Otto, M. W., Carpenter, D., Ross, R., & Docherty, J. P. (2004). The Expert Consensus Guideline Series. Treatment of bipolar disorder 2004. Postgraduate Medicine Special Report, December, 1–119.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–602.CrossRefGoogle Scholar
Ketter, T. A., & Calabrese, J. R. (2002). Stabilization of mood from below versus above baseline in bipolar disorder: A new nomenclature. Journal of Clinical Psychiatry, 63, 146–151.CrossRefGoogle Scholar
Kratochvil, C. J., Vitiello, B., Walkup, J., Emslie, G., Waslick, B. D., Weller, E. B., et al. (2006). Selective serotonin reuptake inhibitors in pediatric depression: Is the balance between benefits and risks favorable? Journal of Child and Adolescent Psychopharmacology, 16, 11–24.Google Scholar
Kupfer, D. J., Carpenter, L. L., & Frank, E. (1988). Is bipolar II a unique disorder? Comprehensive Psychiatry, 29, 228–236.Google Scholar
Kupfer, D. J., Frank, E., Grochocinski, V. J., Luther, J. F., Houck, P. R., Swartz, H. A., et al. (2000). Stabilization in the treatment of mania, depression and mixed states. Acta Neuropsychiatrica, 12, 110–114.CrossRefGoogle Scholar
Lam, D. H., Watkins, E. R., Hayward, P., Bright, J., Wright, K., Kerr, N., et al. (2003). A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: Outcome of the first year. Archives of General Psychiatry, 60, 145–152.CrossRefGoogle Scholar
Leverich, G. S., Altshuler, L. L., Frye, M. A., Suppes, T., McElroy, S. L., Keck, P. E., et al. (2006). Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. American Journal of Psychiatry, 163, 232–239.CrossRefGoogle Scholar
Lotufo-Neto, F., Trivedi, M., & Thase, M. E. (1999). Metaanalysis of the reversible inhibitors of monoamine oxidase type A moclobemide and brofaromine in the treatment of depression. Neuropsychopharmacology, 20, 226–247.CrossRefGoogle Scholar
Marangell, L. B., Martinez, J. M., Ketter, T. A., Bowden, C. L., Goldberg, J. F., Calabrese, J. R., et al. (2004). Lamotrigine treatment of bipolar disorder: Data from the first 500 patients in STEP-BD. Bipolar Disorders, 6, 139–143.CrossRefGoogle Scholar
March, J., Silva, S., Petrycki, S., Curry, J., Wells, K., Fairbank, J., et al. (2004). Fluoxetine, cognitive–behavioral therapy, and their combination for adolescents with depression—Treatment for adolescents with depression study (TADS) randomized controlled trial. Journal of the American Medical Association, 292, 807–820.Google Scholar
McIntyre, R. S., Mancini, D. A., McCann, S., Srinivasan, J., Sagman, D., & Kennedy, S. H. (2002). Topiramate versus Bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: A preliminary single-blind study. Bipolar Disorders, 4, 207–213.CrossRefGoogle Scholar
Melkersson, K., & Dahl, M. L. (2004). Adverse metabolic effects associated with atypical antipsychotics—Literature review and clinical implications. Drugs, 64, 701–723.CrossRefGoogle Scholar
Miklowitz, D. J., George, E. L., Richards, J. A., Simoneau, T. L., & Suddath, R. L. (2003). A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Archives of General Psychiatry, 60, 904–912.CrossRefGoogle Scholar
Miklowitz, D. J., & Goldstein, M. J. (1997). Bipolar disorder. A family-focused treatment approach. New York: Guilford Press.
Miklowitz, D. J., Simoneau, T. L., George, E. L., Richards, J. A., Kalbag, A., Sachs-Ericsson, N., et al. (2000). Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy. Biological Psychiatry, 48, 582–592.CrossRefGoogle Scholar
Murray, C. J. L., & Lopez, A. D. (1996). Evidence-based health policy—Lessons from the Global Burden of Disease Study. Science, 274, 740–741.CrossRefGoogle Scholar
Nemeroff, C. B., Evans, D. L., Gyulai, L., Sachs, G. S., Bowden, C. L., Gergel, I. P., et al. (2001). Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. American Journal of Psychiatry, 158, 906–912.CrossRefGoogle Scholar
Nemeroff, C. B., Schatzberg, A. F., Goldstein, D. J., Detke, M. J., Mallinckrodt, C., Lu, Y., et al. (2002). Duloxetine for the treatment of major depressive disorder. Psychopharmacology Bulletin, 36, 106–132.Google Scholar
Newcomer, J. W. (2005). Second-generation (atypical) antipsychotics and metabolic effects: A comprehensive literature review. CNS Drugs, 19(Suppl. 1), 1–93.CrossRefGoogle Scholar
Nierenberg, A. A., Miyahara, S., Spencer, T., Wisniewski, S. R., Otto, M. W., Simon, N., et al. (2005). Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: Data from the first 1000 STEP-BD participants. Biological Psychiatry, 57, 1467–1473.CrossRefGoogle Scholar
Nierenberg, A. A., Ostacher, M. J., Calabrese, J. R., Ketter, T. A., Marangell, L. B., Miklowitz, D. J., et al. (2006). Treatment-resistant bipolar depression: A STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. American Journal of Psychiatry, 163, 210–216.CrossRefGoogle Scholar
Peet, M. (1994). Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. British Journal of Psychiatry, 164, 549–550.CrossRefGoogle Scholar
Perlis, R. H., Miyahara, S., Marangell, L. B., Wisniewski, S. R., Ostacher, M., Delbello, M. P., et al. (2004). Long-term implications of early onset in bipolar disorder: Data from the first 1000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Biological Psychiatry, 55, 875–881.CrossRefGoogle Scholar
Perris, C. (1966). A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. Acta Psychiatrica Scandinavica, 42, 1–188.Google Scholar
Ryan, N. D., Puig-Antich, J., Rabinovich, H., Fried, J., Ambrosini, P., Meyer, V., et al. (1989). MAOIs in adolescent major depression unresponsive to tricyclic antidepressants. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 755–758.Google Scholar
Sachs, G. S., Lafer, B., Stoll, A. L., Banov, M., Thibault, A. B., Tohen, M., et al. (1994). A double-blind trial of bupropion versus desipramine for bipolar depression. Journal of Clinical Psychiatry, 55, 391–393.Google Scholar
Sachs, G. S., & Thase, M. E. (2000). Bipolar disorder therapeutics: Maintenance treatment. Biological Psychiatry, 48, 573–581.CrossRefGoogle Scholar
Silverstone, T. (2001). Moclobemide vs. imipramine in bipolar depression: A multicentre double-blind clinical trial. Acta Psychiatrica Scandinavica, 104, 104–109.Google Scholar
Simon, G. E., Ludman, E. J., Unutzer, J., Bauer, M. S., Operskalski, B., & Rutter, C. (2005). Randomized trial of a population-based care program for people with bipolar disorder. Psychologic Medicine, 35, 13–24.CrossRefGoogle Scholar
Smith, D., Dempster, C., Glanville, J., Freemantle, N., & Anderson, I. (2002). Efficacy and tolerability of venlafaxine compared with selective serotonin reuptake inhibitors and other antidepressants: A meta-analysis. British Journal of Psychiatry, 180, 396–404.CrossRefGoogle Scholar
Solhkhah, R., Wilens, T. E., Daly, J., Prince, J. B., Van Patten, S. L., & Biederman, J. (2005). Bupropion SR for the treatment of substance-abusing outpatient adolescents with attention/deficit/hyperactivity disorder and mood disorders. Journal of Child and Adolescent Psychopharmacology, 15, 777–786.CrossRefGoogle Scholar
Stoll, A. L., Mayer, P. V., Kolbrener, M., Goldstein, E., Suplit, B., Lucier, J., et al. (1994). Antidepressant-associated mania: A controlled comparison with spontaneous mania. American Journal of Psychiatry, 151, 1642–1645.Google Scholar
Strober, M., & Carlson, G. (1982). Predictors of bipolar illness in adolescents with major depression: A follow-up investigation. Adolescent Psychiatry, 10, 299–319.Google Scholar
Suppes, T., Dennehy, E. B., Swann, A. C., Bowden, C. L., Calabrese, J. R., Hirschfeld, R. M. A., et al. (2002). Report of the Texas concensus conference panel on medication treatment of bipolar disorder 2000. Journal of Clinical Psychiatry, 63, 288–299.CrossRefGoogle Scholar
Swann, A. C., Bowden, C. L., Calabrese, J. R., Dilsaver, S. C., & Morris, D. D. (2002). Pattern of response to divalproex, lithium, or placebo in four naturalistic subtypes of mania. Neuropsychopharmacology, 26, 530–536.CrossRefGoogle Scholar
Thase, M. E. (1998). Effects of venlafaxine on blood pressure: A meta-analysis of original data from 3744 depressed patients. Journal of Clinical Psychiatry, 59, 502–508.CrossRefGoogle Scholar
Thase, M. E. (2004). Comparing the efficacy of the newer antidepressants. In I. Gilaberte (Ed.), Neuvas perspectivas en la depresión (pp. 253–286). Madrid: Aula Médica Endiciones.
Thase, M. E. (2005). Bipolar depression: Issues in diagnosis and treatment. Harvard Review of Psychiatry, 13, 257–271.CrossRefGoogle Scholar
Thase, M. E., Bhargava, M., & Sachs, G. S. (2003). Treatment of bipolar depression: Current status, continued challenges, and the STEP-BD approach. Psychiatric Clinics of North America, 26, 495–518.CrossRefGoogle Scholar
Thase, M. E., Entsuah, A. R., & Rudolph, R. L. (2001). Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors. British Journal of Psychiatry, 178, 234–241.CrossRefGoogle Scholar
Thase, M. E., Friedman, E. S., & Howland, R. H. (2000). Venlafaxine and treatment-resistant depression. Depression and Anxiety, 12, 55–62.3.0.CO;2-X>CrossRefGoogle Scholar
Thase, M. E., Haight, B. R., Richard, N., Rockett, C. B., Mitton, M., Modell, J. G., et al. (2005). Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: A meta-analysis of original data from 7 randomized controlled trials. Journal of Clinical Psychiatry, 66, 974–981.CrossRefGoogle Scholar
Thase, M. E., MacFadden, W., Weisler, R. H., Chang, W., Paulsson, B., Khan, A., et al. (in press). Efficacy of quetiapine monotherapy in bipolar I and II depression: A confirmatory double-blind, placebo-controlled study (the Bolder II study). Journal of Clinical Psychopharmacology.
Thase, M. E., Mallinger, A. G., McKnight, D., & Himmelhoch, J. M. (1992). Treatment of imipramine resistant recurrent depression: IV. A double-blind, crossover study of tranylcypromine in anergic bipolar depression. American Journal of Psychiatry, 149, 195–198.Google Scholar
Thase, M. E., & Sachs, G. S. (2000). Bipolar depression: Pharmacotherapy and related therapeutic strategies. Biological Psychiatry, 48, 558–572.CrossRefGoogle Scholar
Thase, M. E., Tran, P. V., Wiltse, C., Pangallo, B. A., Mallinckrodt, C., & Detke, M. J. (2005). Cardiovascular profile of duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine. Journal of Clinical Psychopharmacology, 25, 132–140.CrossRefGoogle Scholar
Thase, M. E., Trivedi, M. H., & Rush, A. J. (1995). MAOIs in the contemporary treatment of depression. Neuropsychopharmacology, 12, 185–219.CrossRefGoogle Scholar
Tohen, M., Vieta, E., Calabrese, J., Ketter, T. A., Sachs, G., Bowden, C., et al. (2003). Efficacy of olanzapine and olanzapine–fluoxetine combination in the treatment of bipolar I depression. Archives of General Psychiatry, 60, 1079–1088.CrossRefGoogle Scholar
Tondo, L., Isacsson, G., & Baldessarini, R. J. (2003). Suicidal behaviour in bipolar disorder: Risk and prevention. CNS Drugs, 17, 491–511.CrossRefGoogle Scholar
Vieta, E., Martinez-Aran, A., Goikolea, J. M., Torrent, C., Colom, F., Benabarre, A., et al. (2002). A randomized trial comparing paroxetine and venlafaxine in the treatment of bipolar depressed patients taking mood stabilizers. Journal of Clinical Psychiatry, 63, 508–512.CrossRefGoogle Scholar
Young, L. T., Joffe, R. T., Robb, J. C., MacQueen, G. M., Marriott, M., & Patelis-Siotis, I. (2000). Double-blind comparison of addition of a second mood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression. American Journal of Psychiatry, 157, 124–126.CrossRefGoogle Scholar
Youngstrom, E., Meyers, O., Demeter, C., Youngstrom, J., Morello, L., Piiparinen, R., et al. (2005). Comparing diagnostic checklists for pediatric bipolar disorder in academic and community mental health settings. Bipolar Disorders, 7, 507–517.CrossRefGoogle Scholar