David N. Osser, MD

What is the best evidence-based medication treatment for acute bipolar II depression?

"This study served as a sobering reminder of the significant frequency of this disfiguring and sometimes disabling adverse effect, which can be irreversible."

When should you monitor electrocardiograms in patients taking lithium?

"Despite this new study and the need for further research, the best recommendation at this time regarding lithium in patients with bipolar disorder who are suicidal would be to consider it a worthwhile option."

Up to 20% of patients with bipolar disorder have 4 or more medications, so it is important to be aware of these common drug-drug interactions.

Here are a few reminders to help avoid both toxicity and loss of effectiveness.

Because patients with bipolar disorder often have underlying comorbidities, a thorough diagnosis is imperative.

Have you had difficulty with differential diagnosis when patients have manic symptoms and psychosis? One doctor discusses the related DSM-5 criteria changes and some of their implications for psychopharmacology.

This infrequent, but important, toxic effect of lithium deserves increased awareness.

Major depressive episode and bipolar disorders: same DSM-5 diagnostic criteria, but very different disorders.

Bipolar disorder and pregnancy: what considerations need to be kept in mind?

A rare robust finding from a study on bipolar depression.

Higher lithium levels are associated with a greater risk of long-term kidney harm and more frequent depressive episodes. This bipolar update reviews ways to minimize renal side effects.

Why does prazosin appear to be the safest and most effective medication for select patients with comorbid PTSD?

Prazosin appears to be effective and perhaps the best medication for selected patients, including those with bipolar disorder.

Many patients with bipolar and other psychiatric disorders believe it is better to wait to address cigarette and other nicotine use. Here is why that is not necessarily the case.

As we learn about the effect of COVID-19 on patients with bipolar and other psychiatric disorders, clinicians should be prepared to ask questions to uncover new syndromic behaviors.

Although clinicians and patients may wish otherwise, the comorbidity of ADHD and bipolar disorder needs to be considered.

Dr Osser discusses 4 new algorithms to help improve your practice.

The psychiatric prescribing clinician may be called upon to treat pain comorbid with bipolar disorder.

David Osser, MD, comments on the low priority of valproate for treating patients with bipolar disorder.

Oxcarbazepine might be considered for patients who you want to treat with carbamazepine for mania (as monotherapy or adjunct) but for whom it would be unsafe or who have been unable to tolerate it.

There are some off-label proposed uses for topiramate in comorbidities that are common in patients with bipolar disorder. What does the evidence say?

Valproate/divalproex appears to be considerably overused in the US; the use of lithium, second-generation antipsychotics, and carbamazepine should be more prominent in treatment decisions for patients with bipolar mania.

Do you prescribe antidepressants for your patients with bipolar depression? If so, think again, and consider results from these studies.

Regardless of whatever short-term benefit patients perceive from cannabis, the evidence points clearly to an association between usage and worsening course of bipolar disorder over time.

Do you need help persuading patients to try lithium?

There appears to be some confusion regarding the efficacy of aripiprazole in bipolar mania and depression and for preventing bipolar episodes.