![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Objectives. These guidelines are based on a first edition that was published in 2002, and have been edited and updated with the available scientific evidence until September 2009. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute bipolar depression in adults. Methods. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into six levels of evidence (A–F). As these guidelines are intended for clinical use, the scientific evidence was finally assigned different grades of recommendation to ensure practicability. Results. We identified 10 pharmacological monotherapies or combination treatments with at least limited positive evidence for efficacy in bipolar depression, several of them still experimental and backed up only by a single study. Only one medication was considered to be sufficiently studied to merit full positive evidence. Conclusions. Although major advances have been made since the first edition of this guideline in 2002, there are many areas which still need more intense research to optimize treatment. The majority of treatment recommendations is still based on limited data and leaves considerable areas of uncertainty.
Acknowledgements
We would like to specially thank Mrs Berenike Oppermann, WFSBP office Vienna, for general and editorial assistance.
HG and EV also want to express their gratitude to Dr Konstantinos Fountoulakis as many of the evidence used in this article was collected when co-authoring two recent review articles with Dr. Fountoulakis.
Statement of interests of principal authors
Heinz Grunze received grants/ research support, consulting fees and honoraria within the last 3 years from Astra Zeneca, Bial, BMS, Cephalon, Eli Lilly, Glaxo-Smith Kline, Janssen-Cilag, Organon, Pfizer Inc, Sanofi-Aventis, Servier, UBC and UCB Belgium.
Eduard Vieta received grants/research support, consulting fees and honoraria within the last 3 years from Almirall, AstraZeneca, Bial, Bristol-Myers Squibb, Eli Lilly, Forest Research Institute, Glaxo-Smith-Kline, Janssen-Cilag, Jazz, Lundbeck, Merck-Sharp and Dohme, Novartis, Organon, Otsuka, Pfizer Inc, Sanofi-Aventis, Servier, Shering-Plough, UBC, and Wyeth.
Guy Goodwin received grants/research support, consulting fees and honoraria within the last 3 years from AstraZeneca, Bristol-Myers Squibb, Eisai, Eli Lilly, Janssen Cilag, Lundbeck, P1Vital, Sanofi-Aventis, Servier and Wyeth.
Charles Bowden received grants/research support, consulting fees and honoraria within the last 3 years from Abbott Laboratories, Astra Zeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, JDS Inc., Lilly Research, National Institute of Mental Health, Pfizer, R.W. Johnson Pharmaceutical Institute, Sanofi -Aventis, Repligen and the Stanley Medical Research Foundation.
Rasmus W. Licht received research grants, consulting fees and honoraria within the last 3 years from Astra-Zeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen Cilag and Sanofi-Aventis.
Hans-Jürgen Möller received grant/research support, consulting fees and honoraria within the last 3 years from AstraZeneca, Bristol-Myers Squibb, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Merck, Novartis, Organon, Pfizer, Sanofi-Aventis, Sepracor, Servier and Wyeth.
Siegfried Kasper received grants/research support, consulting fees and honoraria within the last 3 years from AstraZeneca, Bristol-Myers Squibb, CSC, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutica, Lundbeck, MSD, Novartis, Organon, Pierre Fabre, Pfizer, Schwabe, Sepracor, Servier and Wyeth.