Treatment of Bipolar Depression

Introduction to Guideline-Based Treatment Options

• The American Academy of Child and Adolescent Psychiatry notes that "low-dose" quetiapine (25-100 mg/day) is commonly misused off-label for insomnia, which is not an evidence-based practice for treating the depressive phase of bipolar disorder 1

Alternative Treatment Options

• The guideline society recommends lithium or valproate as mood stabilizers, or antidepressants (SSRIs preferred over tricyclics) always in combination with a mood stabilizer, never as monotherapy 2
• Olanzapine plus fluoxetine combination is also recommended as an FDA-approved option for bipolar depression in adults 3, 1, 4