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Study Suggests New Treatment Approach May be Needed for Management of Depression in Some People With Bipolar Disorder
Date:2/11/2009

tients who stopped taking the antidepressant due to lack of effectiveness or worsening depressive symptoms.

"We found that people who had minimal manic symptoms or a "mixed depression" presentation were at greatest risk for experiencing TEM," says Dr. Frye.

Experts have begun to acknowledge that the common understanding of bipolar illness, once thought to be a disorder with two distinct phases (a manic upswing and a depressive downswing), may be incomplete. A recent study of over 1,300 patients conducted by Joseph Goldberg, M.D., Mount Sinai School of Medicine, reported that two-thirds of the depressed bipolar patients had minimal or mild manic symptoms "mixed" together.

"We're learning that this illness does not occur in two neat, clear-cut phases, but rather a mix of the two," says Dr. Frye. "Our data would suggest that people with mixed depression may need to stay away from antidepressants and work with their health care providers to find alternative treatments, such as mood stabilizers, to help manage the depressive phase of their illness." Further research is encouraged to better understand the best treatment for these mixed presentations.

Other authors for this article include: Gerhard Helleman, Ph.D., David Geffen School of Medicine at UCLA, Los Angeles; Susan McElroy, M.D., University of Cincinnati College of Medicine; Lori Altshuler, M.D., David Geffen School of Medicine at UCLA, Los Angeles; David Black, Ph.D., Pediatric and Developmental Neuropsychiatry, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, Md., and David Geffen School of Medicine at UCLA, Los Angeles; Paul Keck Jr., M.D., University of Cincinnati College of Medicine; Willem Nolen, M.D., Ph.D., University Medical Center Groningen, University of Groningen, the Netherlands; Ralph Kupka, M.D., Ph.D., Altrecht Institute for Mental He
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SOURCE Mayo Clinic
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