The relationship between bipolar disorder and ADHD remains unclear; however, this combined condition may represent an important genetic and clinical subtype with distinct psychopathology, familiality, and treatment response.
Mood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
In a PsychCongress presentation on perinatal mood disorders, Marlene Freeman, MD, stressed that treatment is essential for women with mood disorders—but whether to treat becomes complicated during a women’s reproductive years.
Nonpharmacological interventions—such as mind-body interventions—can improve a partial response to antidepressants via stress reduction, improved physical functioning, increased socialization, and reduced risks of polypharmacy.
Most often, psychiatric medications are discontinued unilaterally by the patient, without the psychiatrist’s input or consent. Setting the stage early with a discussion about medication discontinuation is time well spent. More in this CME.
A recent meta-analysis supports evidence of the effectiveness of the fixed olanzapine/fluoxetine combination (Symbyax) in treating the depressive phase of bipolar disorder. Response was ranked higher, but with no more adverse effects, than with treatment with olanzapine alone.