Focus 1:15-31 (2003)
© 2003 American Psychiatric Association
Relapse Prevention and Bipolar Disorder: A Focus on Bipolar Depression
Mark Hyman Rapaport, M.D. and
Deborah J. Hales, M.D.
From the Department of Psychiatry, University of California, San Diego, School of Medicine.
Correspondence: Address reprint requests to Dr. Rapaport, Department of Psychiatry and Mental Health, Office of the Chairman, 8730 Alden Drive, Suite TH C306, Los Angeles, CA 90048; mark.rapaport{at}cshs.org, e-mail.
There is growing evidence that bipolar disorder and bipolar spectrum disorders are both prevalent and pernicious. They may cause profound impairment in all aspects of a patient’s life and frequently disrupt the structure of the patient’s entire social network. Beyond a consensus that most patients with bipolar disorder will require continuous treatment, relatively little is known about the long-term management of either bipolar I or bipolar II disorder. Although managing depression and depressive symptoms is the greatest challenge faced by patients with these disorders and the physicians who treat them, prevention of mania, rather than depression, has been the focus of most research efforts. This review article will summarize research evidence regarding the utility of lithium, anticonvulsant agents, antipsychotic medications, antidepressant medications, and electroconvulsive therapy in preventing relapse of depressive symptoms for patients with bipolar I and bipolar II disorders.
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