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首页> 外文期刊>The journal of clinical psychiatry >The treatment of bipolar depression.
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The treatment of bipolar depression.

机译：双相抑郁症的治疗。

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BACKGROUND: The treatment of bipolar depression represents a relatively understudied area in clinical psychiatry. The depressive phases of bipolar disorder can be very disabling, with significant associated comorbidity and suicide risk, impairment in functioning, and infringement on quality of life. We review the current evidence for the management of bipolar depression. METHOD: References for this review were obtained through MEDLINE searches of the medical literature on subjects pertaining to the treatment of bipolar depression. Search terms included bipolar depression, antidepressants, and bipolar disorder. Only publications in English are reviewed here. RESULTS: Lithium is currently the gold standard and most appropriate initial treatment for the depressive phase of bipolar disorder. Other mood stabilizers have demonstrated preliminary efficacy. Of the antidepressants, bupropion and the selective serotonin reuptake inhibitors may be associated with less risk of inducing hypomania, mania, and rapid cycling compared with tricyclic antidepressants. Monoamine oxidase inhibitors should be considered for patients with anergic bipolar depression. Electroconvulsive therapy has been shown to be highly efficacious. Other treatment modalities, including psychotherapy, sleep deprivation, phototherapy, and newer medications, require further research. CONCLUSIONS: Although the treatment of bipolar depression can be a complicated clinical task, the treatment armamentarium is expanding. Further research, especially in the form of randomized controlled trials, is warranted. Clinicians should be familiar with general guidelines for the use of psychopharmacologic agents for treating bipolar depression.
机译：背景：双相抑郁症的治疗代表了临床精神病学领域中一个相对未被研究的领域。双相情感障碍的抑郁期可能非常残障，伴有明显的合并症和自杀风险，功能受损以及生活质量受到损害。我们回顾了目前治疗双相抑郁症的证据。方法：本综述的参考文献是通过MEDLINE搜索医学文献中有关双相抑郁症的受试者获得的。搜索词包括躁郁症，抗抑郁药和躁郁症。此处仅审查英文出版物。结果：锂目前是双相情感障碍抑郁期的金标准和最合适的初始治疗方法。其他情绪稳定剂已显示出初步功效。在抗抑郁药中，与三环类抗抑郁药相比，安非他酮和选择性5-羟色胺再摄取抑制剂诱导低躁狂，躁狂和快速循环的风险可能较小。对于双相性精神抑郁症患者，应考虑使用单胺氧化酶抑制剂。电惊厥疗法已被证明是高度有效的。其他治疗方式，包括心理疗法，睡眠剥夺，光疗和更新的药物，需要进一步研究。结论：尽管双相抑郁症的治疗可能是一项复杂的临床任务，但治疗性武器库正在扩大。值得进一步研究，尤其是以随机对照试验的形式。临床医生应熟悉使用心理药物治疗双相抑郁的一般指导原则。

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