Accurate Diagnosis, Appropriate Treatment Selection

CE / CME

eCase: Accurate Diagnosis Leads to Appropriate Treatment Selection in Patients With Bipolar Depression

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurses: 1.00 Nursing contact hour, including 1.00 hour of pharmacotherapy credit 

Social Workers: 1.00 ASWB ACE CE Credit

Pharmacists: 1.00 contact hour (0.1 CEUs)

Psychologists: 1.00 APA CE Credit

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Released: September 30, 2022

Expiration: September 29, 2023

Leslie Citrome
Leslie Citrome, MD, MPH

Activity

Progress
1
Course Completed
Which of the following is true regarding major depressive disorder (MDD) and bipolar depression?
Which of the following is true regarding FDA-approved treatments for bipolar depression?
Lumateperone, cariprazine, and lurasidone are distinguished from quetiapine and olanzapine/fluoxetine combination principally by?

References

  1. Kessler RC, Rubinow DR, Holmes C, et al. The epidemiology of DSM-III-R bipolar I disorder in a general population survey. Psychol Med. 1997;27:1079.
  2. Blanco C, Compton WM, Saha TD, et al. Epidemiology of DSM-5 bipolar I disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions – III. J Psychiatr Res. 2017;84:310.
  3. Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018;8:251.
  4. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59:530.
  5. Forte A, Baldessarini RJ, Tondo L, et al. Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. J Affect Disord. 2015;178:71.
  6. Judd LL, Akiskal HS, Schettler PJ, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry. 2003;60:261.
  7. Bowden CL. Strategies to reduce misdiagnosis of bipolar depression. Psychiatr Serv. 2001;52:51.
  8. Berk M, Berk L, Moss K, et al. Diagnosing bipolar disorder: how can we do it better? Med J Aust. 2006;184:459.
  9. Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711.
  10. Valentí M, Pacchiarotti I, Bonnín CM, et al. Risk factors for antidepressant-related switch to mania. J Clin Psychiatry. 2012;73:e271.
  11. Glauser TA, Cerenzia W, Wiley S, et al. Identifying psychiatrists' practice patterns when managing depression in patients with bipolar I disorder: a descriptive study to inform education needs. Postgrad Med. 2013;125:144.
  12. Hirschfeld RM, Cass AR, Holt DC, et al. Screening for bipolar disorder in patients treated for depression in a family medicine clinic. J Am Board Fam Pract. 2005;18:233.
  13. Chen YW, Dilsaver SC. Lifetime rates of suicide attempts among subjects with bipolar and unipolar disorders relative to subjects with other Axis I disorders. Biol Psychiatry. 1996;39:896.
  14. McIntyre RS, Calabrese JR. Bipolar depression: the clinical characteristics and unmet needs of a complex disorder. Curr Med Res Opin. 2019;35:1993.
  15. Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157:1873.
  16. McIntyre RS, Patel MD, Masand PS, et al. The Rapid Mood Screener (RMS): a novel and pragmatic screener for bipolar I disorder. Curr Med Res Opin. 2021;37:135.
  17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. American Psychiatric Association Publishing; 2013. Updated: American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fifth edition, Text Revision. American Psychiatric Association Publishing; 2022.
  18. Suppes T, Silva R, Cucchiaro J, et al. Lurasidone for the treatment of major depressive disorder with mixed features: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2016;173:400.
  19. Citrome L. Food and Drug Administration-approved treatments for acute bipolar depression: what we have and what we need. J Clin Psychopharmacol. 2020;40:334.
  20. Citrome L. Treatment of bipolar depression: making sensible decisions. CNS Spectr. 2014;19(suppl 1):4.
  21. Muzina DJ, Colangelo E, Manning JS, et al. Differentiating bipolar disorder from depression in primary care. Cleve Clin J Med. 2007;74:89.
  22. Manning JS. Tools to improve differential diagnosis of bipolar disorder in primary care. Prim Care Companion J Clin Psychiatry. 2010;12(suppl 1):17.
  23. Calabrese JR, Durgam S, Satlin A, et al. Efficacy and safety of lumateperone for major depressive episodes associated with bipolar i or bipolar ii disorder: a phase 3 randomized placebo-controlled trial. Am J Psychiatry. 2021;178:1098.
  24. Quetiapine fumarate extended-release [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2022.
  25. Tsapakis EM, Preti A, Mintzas MD, et al. Adjunctive treatment with psychostimulants and stimulant-like drugs for resistant bipolar depression: a systematic review and meta-analysis. CNS Spectr. 2020:1.
  26. Lumateperone [prescribing information]. New York, NY: Intra-Cellular Therapies, Inc.; 2022.
  27. Lurasidone hydrochloride [prescribing information]. Marlborough, MA: Sunovion Pharmaceuticals Inc.; 2022.