Antipsychotic drugs for depression in bipolar disorder
Antipsychotic medications are used to treat bipolar disorder and the depressive phase in bipolar disorder. Their use is justified, since in 50% of patients psychotic symptoms are noted.
The use of classical antipsychotics is limited by a number of points. Patients with bipolar disorder are at risk of developing extrapyramidal pathology and dyskinesia. Also, classical antipsychotics themselves cause depression. Therefore, when eliminating a psychotic attack, it is better to use atypical antipsychotics.
The study of the action of quetiapine and olanzapine showed good tolerance, a decrease in psychotic manifestations and an antidepressant effect. With the combination of olanzapine to fluoxetine BAR treatment was more effective than monoterpapiya olanzapine . Studies on the MADRS scale showed that with treatment with olanzapine alone, remission occurred on day 57, and with combination therapy – on day 32.
When treating bipolar disorder with atypical antipsychotics, side effects were observed in the form of drowsiness, weight gain, dry mouth, and increased appetite.
Quentipine eliminated anxiety in depressed patients.
A study conducted on 16 patients with refractory depression with ineffective antidepressant treatment showed that antidepressant therapy alone was unproductive. And the combination of lithium preparations with antidepressants led to remission.
Risperidone had no antidepressant effect, but it did potentiate the effect of citalopram in resistant depression. Atypical antipsychotics influenced not only the main symptoms of depression, but also suppressed the development of psychotic symptoms. Did not cause phase inversion. Well tolerated by patients.
At this point in time, the lack of knowledge of the therapeutic arsenal of the depressive phase of bipolar disorder does not allow developing the correct treatment algorithm. But the general tendency is not only to eliminate a depressive episode, but also to reduce suicidal attempts and to prevent phase inversion.