Avery Lindsay M, Drayton Shannon J
South Carolina College of Pharmacy, Medical University of South Carolina, Charleston, SC, USA.
South Carolina College of Pharmacy, Medical University of South Carolina, Charleston, SC, USA
Int J Psychiatry Med. 2016;51(2):145-59. doi: 10.1177/0091217416636576.
Bipolar affective disorder is a debilitating illness that manifests as cyclical episodes of mood elevation and depression, but the treatment of the depressive episodes (i.e., bipolar depression) differs considerably from the treatment of major depressive disorder. In bipolar affective disorder, it is well known that patients spend a significantly greater amount of time in depressive episodes than manic or hypomanic episodes, yet there are currently just three Food and Drug Administration-approved agents for the treatment of bipolar depression: (1) olanzapine/fluoxetine combination (2) quetiapine, both immediate- and extended-release, and (3) lurasidone. The literature review presented here focuses on the clinical trials that led to the Food and Drug Administration-approval of these second generation antipsychotics in the treatment of bipolar depression. The discussion highlights key considerations regarding overall treatment strategies to aid clinicians in the selection of pharmacologic agents. Recommended monitoring parameters, potential adverse effects, and pertinent counseling points for second generation antipsychotics used in bipolar depression are included.
双相情感障碍是一种使人衰弱的疾病，表现为情绪高涨和抑郁的周期性发作，但抑郁发作（即双相抑郁）的治疗与重度抑郁症的治疗有很大不同。在双相情感障碍中，众所周知，患者处于抑郁发作的时间比躁狂或轻躁狂发作的时间长得多，但目前美国食品药品监督管理局（FDA）仅批准了三种用于治疗双相抑郁的药物：（1）奥氮平/氟西汀组合；（2）喹硫平，包括速释和缓释剂型；（3）鲁拉西酮。本文献综述聚焦于导致这些第二代抗精神病药物获得FDA批准用于治疗双相抑郁的临床试验。讨论突出了有关总体治疗策略的关键考量因素，以帮助临床医生选择药物。还包括双相抑郁中使用第二代抗精神病药物的推荐监测参数、潜在不良反应及相关咨询要点。
