Psychiatria pre prax 4/2012

New therapeutic guidelines for the treatment of bipolar disorder II

Actually, we do have to use therapeutic guidelines for the tratment of bipolar disorder based on the results of clinical research. Most of these recommendations there are for the treatment of manic episode, mixed affective episode respectively, less for the treatment of depressive episode. There are only some recommendations for the treatment of bipolar disorder. Comparing to treatment of unipolar depression, bipolar disorder II (BP II) has its own specification. The most evident difference is about using of thymostabilizators in treatment of bipolar depression or atypical antipsychotic, either combination with antidepressant, or without it. Treatment of bipolar depression only with antidepressant monotherapy is suboptimal in regard of switch to mania. As optimal treatment for BP II (and for bipolar depression generally) appear psychopharmacs with adequate antidepressive power and risk-free for switching to hypomania, mania or mixed states.

Keywords: bipolar disorder II, bipolar depression, atypical antipsychotic, mood stabilizer, antidepresant.