oa SA Pharmaceutical Journal - Decisions about depression : treatment options depend on diagnosis : review

Volume 77, Issue 8
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017



This article explores the clinical and therapeutic differences between major depressive disorder and bipolar depression. Although both are disorders of suppressed mood with similar symptoms, the two syndromes respond differently to medications : Whereas severe major depressive disorder responds to antidepressant medication, either as monotherapy or in combination, there is some evidence that in bipolar depression of all subtypes, response to antidepressants is no greater than to placebo. Quetiapine, lamotrigine, lithium or olanzapine are recommended initially, with antidepressant usage included in combination therapy only at later stages of management. Further research is necessary to determine pathophysiological differences between these two disorders and ideal treatment approaches.

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