Comment on Guideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder, 2nd Edition
In the year since publication of the Watch, the results of several clinically important studies have been published. The efficacy of aripiprazole (1) and divalproex extended release (2) in the acute treatment of mania were each demonstrated compared to placebo. Olanzapine and risperidone monotherapy were equivalent in the acute treatment of mania (3). The efficacy of quetiapine in the acute treatment of bipolar depression was confirmed in a second study (4), and the drug has received FDA approval for the treatment of bipolar depression. The olanzapine/fluoxetine combination was found to be superior in efficacy compared to lamotrigine, but had considerably more side effects (5). Both aripiprazole (6) and olanzapine (7) were found to be superior to placebo in maintenance therapy. Several studies have supported the use of cognitive behavioral therapy or systematic psychoeducation to prolong remission (8–10).
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10 Ball et al. A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change. J Clin Psych 2006; 67:277–286Crossref, Google Scholar