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bipolar II disorder; bipolar depression

Clinical manifestations: - both a hypomanic episode & a major depressive episode - no manic episodes Management: - see bipolar disorder - bright light mid-day (noon) may improve depression [2] - aspirin 81 mg QD may be of benefit (NNT=4) [3] - minocycline alone or in combination with aspirin may or may not be of benefit [3] - CoQ10 may improve symptoms of depression [4] - psylocybin 25 mg PO single dose [6] - lumateperone (Caplyta) FDA-approved to treat with depressive episodes associated with bipolar I disorder & bipolar II disorder as monotherapy or adjunctive therapy with lithium or valproate [5]

General

bipolar affective disorder

References

  1. NEJM Knowledge+ Question of the Week. Aug 15, 2017 https://knowledgeplus.nejm.org/question-of-week/1288/
  2. Sit DK, McGowan J, Wiltrout C et al. Adjunctive bright light therapy for bipolar depression: A randomized double-blind placebo-controlled trial. Am J Psychiatry 2017 Oct 3; PMID: 28969438 http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.16101200
  3. Savitz JB, Teague TK, Misaki M et al. Treatment of bipolar depression with minocycline and/or aspirin: An adaptive, 2 2 double-blind, randomized, placebo-controlled, phase IIA clinical trial. Transl Psychiatry. 2018 Jan 24;8(1):27 PMID: 29362444 Free PMC Article
  4. Mehrpooya M et al. Evaluating the effect of coenzyme Q10 augmentation on treatment of bipolar depression: A double-blind controlled clinical trial. J Clin Psychopharmacol 2018 Oct; 38:460. PMID: 30106880
  5. Brooks M FDA Grants New Indication to Lumateperone (Caplyta) for Bipolar Depression. Medscape. December 20, 2021 https://www.medscape.com/viewarticle/965134
  6. Aaronson ST, van der Vaart A, Miller T et al Single-Dose Synthetic Psilocybin With Psychotherapy for Treatment-Resistant Bipolar Type II Major Depressive Episodes. A Nonrandomized Controlled Trial. JAMA Psychiatry. Published online December 6, 2023 PMID: 38055270 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2812443 - Yaden DB, Gukasyan N, Nayak SM et al Psilocybin in Bipolar II Study Provides Preliminary Data on Safety. JAMA Psychiatry. Published online December 6, 2023. PMID: 38055240 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2812445