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Bipolar depression causes significant functional impairment and is associated with cognitive impairment and death by suicide. Although the treatment options are many, choosing among them is challenging. Previous meta-analyses of bipolar depression treatment have compared monotherapies only within the same class. The current investigators conducted a network meta-analysis of studies on drugs from three classes.
The analysis included 50 double-blind, randomized, controlled trials of 11,448 participants with bipolar disorder who were acutely depressed. Trials involving mostly patients experiencing mixed or manic states and studies of augmentation or adjunctive therapies were excluded, except for combination olanzapine/fluoxetine. Median follow-…