Antidepressant Monotherapy May Prevent Relapse in Bipolar II Depression

Practice guidelines regarding maintenance therapy for bipolar II disorder recommend monotherapy with a mood stabilizer and discontinuation of antidepressants relatively soon (12–20 weeks) after recovery from depression to avoid switches into hypomania or mania. However, such recommendations are based on studies of mixed populations of patients with bipolar I and bipolar II disorder. Moreover, the scant data regarding maintenance antidepressant monotherapy in bipolar II disorder suggest continued efficacy and low switch rates.

To examine this issue further, investigators randomized 129 outpatients with bipolar II disorder and current depression to 12 weeks of antidepressant therapy with venlafaxine or mood stabilization with lithium. Patients…