Bipolar Depression: An Unmet Need in Bipolar Disorder. (Advertisement)

Article excerpt

Although bipolar disorder covers a spectrum of mood episodes, research and treatments have focused more on mania than on depression. (1) Currently approved mood stabilizers--standard first-line regimens for bipolar disorder-- target mania rather than. (1,2) To date, there is no FDA-approved medication for the treatment of bipolar depression. Because patients with bipolar disorder often are hospitalized during severe manic episodes, clinicians are very familiar with the hazardous features of mania. However, depressive episodes also can be a significant clinical challenge. (2,3)

BIPOLAR DEPRESSIVE EPISODES

Depressive episodes in bipolar disorder can account for up to 80% of all mood episodes during the later decades of a patient's life. (4) These episodes often last longer than manic episodes and can be more dangerous and more challenging to treat. (2,4) Depressive states are also the most lethal in bipolar disorder, with the vast majority of suicides attempted during these states. (5) Yet, until recently, treatment of bipolar depression received minimal attention. Bipolar disorder affects approximately 1.2% of American adults, or more than 2.2 million people. (2) However, due to the high rate of misdiagnosis, the actual incidence of bipolar disorder may be even higher. (3)

MISDIAGNOSIS

Misdiagnosis remains one of the major treatment challenges in bipolar disorder. During episodes of mania or hypomania, patients tend to experience "highs" or intense bursts of energy. It may not be until the depressive episodes occur that many patients seek treatment. According to a recent survey conducted by the National Depressive and Manic-Depressive Association (NDMDA), a majority of bipolar patients-69% (411/600)-reported they had been misdiagnosed. (3) Of these, a majority (60%) were diagnosed with unipolar depression. (3)

THE MOOD DISORDER QUESTIONNAIRE

The Mood Disorder Questionnaire (MDQ) is the first screening tool created specifically to help differentiate bipolar disorder from other mood disorders. It is a 13-item checklist that addresses symptoms, co-occurrence, and severity of outcome. The MDQ has a high rate of accuracy and is able to identify 7 out of 10 people who have bipolar disorder, which may help reduce the rate of misdiagnosis and its associated risks. …