Jha Manish K, Murrough James W
Depression and Anxiety Center for Discovery and Treatment and Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York City.
Focus (Am Psychiatr Publ). 2019 Jul;17(3):232-237. doi: 10.1176/appi.focus.20190009. Epub 2019 Jul 16.
Bipolar disorder is a chronic illness that affects 2%-4% of U.S. adults during their lifetime. The course of bipolar disorder is commonly characterized by prolonged periods of depression interspersed with manic-hypomanic episodes. Management of depression among patients with bipolar disorder is challenging because of the limited number of medications currently approved by the Food and Drug Administration, the high proportion of patients who do not respond to these medications, and the metabolic and other side effects associated with long-term use of these medications. In addition to reviewing the clinical options available to patients with bipolar depression and their treatment providers, this article presents an evidence-based management approach and discusses the off-label uses of currently available treatments and experimental therapeutics under development.
双相情感障碍是一种慢性疾病，在美国有2% - 4%的成年人在其一生中会受到影响。双相情感障碍的病程通常表现为长时间的抑郁期，并穿插有躁狂 - 轻躁狂发作。双相情感障碍患者的抑郁管理具有挑战性，原因在于目前美国食品药品监督管理局批准的药物数量有限，很大比例的患者对这些药物没有反应，以及长期使用这些药物会带来代谢和其他副作用。除了回顾双相抑郁患者及其治疗提供者可采用的临床选择外，本文还提出了一种基于证据的管理方法，并讨论了现有治疗方法的非标签用途以及正在研发的实验性疗法。
