TIMA 2005 Bipolar Acute Depression

1
TIMA 2005 Bipolar Acute Depression
Response
CONT
Partial Response Or Nonresponse
Li, LTG, QTP, OFC, VPA, or CBZ SSRI, BUP, or
VEN or ECT
Stage 4

• Combinations (OFC combinations 3 drugs)
• Lamotrigine should not be combined with AD
  without antimanic
• Includes VPA and CBZ at this point
• SSRIs include CTP, FLX, PRX, SRT, and FLV
• Some advocate the use of AD earlier but
  evidence is lacking
• Venlafaxine associated with more mania
  induction

BUP bupropion CBZ carbamazepine CTP
citalopram ECT electroconvulsive therapy Li
lithium LTG lamotrigine OFC
olanzapine-fluoxetine combination QTP
quetiapine SSRI selective serotonin reuptake
inhibitor VEN venlafaxine VPA
valproate Suppes T, et al. J Clin Psychiatry.
200566870-886.