Алгоритм терапии БД и Литература


Терапевтическая тактика для лёгкой, умеренной и тяжёлой депрессии без психотических симптомов при БАР I и БАР II идентична (рис. 5).

У больных, не получающих нормотимик, терапию БД следует начинать с препарата этой группы. Если пациент уже получает нормотимик, рекомендуется попытка увеличения его дозы, присоединение кветиапина или использование сочетанной терапии оланзапином и флуоксетином, или добавление второго нормоти-мика и присоединение психотерапии. При неэффективности этих терапевтических мероприятий возможно использование сочетанной терапии нормотимиком и антидепрессантом (преимущественно СИОЗС), который назначается на минимально короткий срок. При использовании комбинированной терапии необходимо учитывать возможные лекарственные взаимодействия препаратов.

При неэффективности второго курса терапии возможна смена нормотимика и/или антидепрессанта, либо, в случае затяжных состояний, нарастающей социальной дезадаптации, — решение вопроса о применении ЭСТ (Prudic, 1990). При неэффективности ЭСТ проводят противорезистентные мероприятия, аналогичные тем, которые используются при резистентной депрессии при рекуррентном депрессивном расстройстве.

Рис. 5. Алгоритм терапии биполярной депрессии

Рис. 5. Алгоритм терапии биполярной депрессии

При тяжёлой БД, а также при наличии суицидальных мыслей уже на первом этапе лечения рекомендуется сочетанная терапия нормотимиком и антидепрессантом (The Expert Consensus Guideline Series, 1996) или использование кветиапина или комбинации оланзапина с флуоксетином. При неэффективности первого курса вначале рекомендуется попытка смены антидепрессанта, затем — нормотимика, либо применение ЭСТ.

Таким образом, в настоящее время не существует лекарственного средства, которое в условиях монотерапии могло бы обеспечить все необходимые при БД эффекты, а именно быстрое купирование депрессивной и психотической симптоматики, предотвращение суицидов и профилактику фаз обоих полюсов. Некоторые препараты представляются весьма перспективными, однако количество хорошо спланированных исследований в этой области остается весьма ограниченным. Не существует и единого консенсуса экспертов относительно этапов терапии БД. Также требуют совершенствования подходы к диагностике БД. Решение этих задач позволит существенно облегчить симптомы заболевания, снизить частоту его обострений и значительно улучшить качество жизни больных с БД.

Литература

  1. Александров А. А. Принципы терапии биполярной депрессии//Вестник БПА, № 12, 2006, с. 45-55.
  2. Костюкова Е. Г., Мосолов С. Н. Современные подходы к диагностике, лечению и профилактике депрессии при биполярном расстройстве//Социальная и клиническая психиатрия, 2003, том 4, с. 106-114.
  3. Мосолов С. Н., Костюкова Е. Г. Клинические рекомендации по терапии маниакальных и смешанных состояний при биполярном расстройстве (проект)//Современная терапия психических расстройств, 2007, том 4, с. 33-46.
  4. Мосолов С. Н., Костюкова Е. Г., Кузавкова М. В. Биполярное аффективное расстройство: диагностика и терапия/под редакцией С.Н. Мосолова М.: МЕДпресс-информ, 2008, с. 15.
  5. Ahlfors U. G., Baastrup Р. С., Dencker S.J. et al. Neuroleptic-induced extrapyramidal side effects in bipolar and schizophrenic patients//Acta Psychiatr. Scand., 1981, Vol. 64, № 3, p. 226-237.
  6. Ahrens B, Muller-Oerlinghausen B. Does lithium exert an independent antisuicidal effect?//Pharmacopsychiatry, 2001, Vol. 34, № 4, p. 132-3.
  7. Akiskal H. S., Pinto Q. The evolving bipolar spectrum: prototypes I, II, III and IV. The Psychiatric clinics of North America. Bipolarity: Beyong classic mania, ed. H. Akiskal. Saunders Co., Philadelphia, 1999, Vol. 22, № 3, Sept., p. 517-535.
  8. Allilaire J.F. Diagnosis of bipolar disorder and rationale of early treatment//Bull. Acad Natl Med. 2010, Vol. 194, № 9, p. 1695-703.
  9. Altshuler L, Suppes T, Black D et al. Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up//Am. J. Psychiatry, 2003, Mb 160, p. 1252-1262.
  10. Amsterdam J., Shults J. Comparison of fluoxetine, olanzapine, and combined fluoxetine plus olanzapine initial therapy of bipolar type I and type II major depression//J Affect Disord, 2005, №87, p. 121-130.
  11. AmsterdAm. J..D., Shults J. Comparison of short-term venlafaxine versus lithium monotherapy for bipolar II major depressive episode: a randomized open-label study//J. Clin. Psychopharmacol., 2008, Vol. 28, № 2, p. 171-81.
  12. Angst J. Switch from depression to mania — a record study over decades between 1920 and 1982//Psychopathology, 1985, Vol. 18 (2-3)., p. 140-54.
  13. Angst J. The course of affective disorders: II. Typology of bipolar manic-depressive illness//J Affect Disord., 2005, Vol. 88, № 2, p. 217-33.
  14. Angst J., Adolfsson R., Benazzi F. et al. The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients//J Affect Disord., 2005, Vol. 88, № 2, p. 217-33.
  15. Angst J, Azorin JM, Bowden CL et al. Prevalence and characteristics of undiagnosed bipolar disorders in patients with a major depressive episode: the BRIDGE study//Arch. Gen. Psychiatry 2011, Vol. 68, №8, p. 791-8.
  16. Angst J, Gamma A, Bowden CL, Azorin JM, Perugi G, Vieta E, Young AH. Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes//Eur Arch Psychiatry Clin Neurosci., 2011, Aug 5. [Epub ahead of print]
  17. APA. Practice guideline for the treatment of patients with bipolar disorder (revision)//Am. J.Psy 2002, №159, p. 1-50.
  18. Azorin JM. Major depression: features indicative of bipolarity?//Encephale., 2011, Vol. 37, suppl. 3, p. 163-8.
  19. Baldessarini R.J. et al. Patterns of psychotropic drug prescription for U.S. patients with diagnoses of bipolar disorders//Psychiatr Serv., 2007, Vol. 58, № 1, p. 89-91.
  20. Ballenger JC. The clinical use of carbamazepine in affective disorders//J. Clin. Psychiatry 1988, №49, p. 13-21.
  21. Benazzi F. Prevalence of bipolarll disorder in outpatient depression. A203-case study in private practice//J. Affect. Disord.,1997, Vol. 43, p. 163-166.
  22. Bocchetta A, Bernardi F, Burrai C, Pedditzi M, Del Zompo M. A double-blind study of L-sulpiride versus amitriptyline in lithium-maintained bipolar depressives//Acta Psychiatr Scand. 1993, Vol. 88, № 6, p. 434-9.
  23. Bowden CL. Lamotrigine in the treatment of bipolar disorder//Expert Opin Pharmacother, 2002, №3, p. 1513-19.
  24. Bowden CL. Diagnosis and impact of bipolar depression//J. Clin. Psychiatry., 2009, Vol. 70, № 9, p. 32.
  25. Brown EB, McElroy SL, Keck PE JR et al. A 7-week, randomized, double-blind trial of olanzapine/fluoxetine combination versus lamotrigine in the treatment of bipolar I depression//]. Clin. Psychiatry., 2006, Vol. 67, № 7, p. 1025-33.
  26. Calabrese P. et al. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression//]. Clin. Psychiatry, 1999, № 60, p. 79-88.
  27. Calabrese JR, Keck PE, Macfadden W et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression//Am. J. Psychiatry, 2005, № 162, p. 1351-1360.
  28. Calabrese JR, Huffman RF, White RL et al. Lamotrigine in the acute treatment of bipolar depression: results of five double-blind, placebo-controlled clinical trials//Bipolar Disord., 2008, Mar, Vol. 10, № 2, p. 323-33.
  29. Cassano G. В., Akiskal H. S. Savino M. et all. Proposed Subtypes of bipolar 2 and related disorders: with hypomanic episodes (or cyclothymia) and with hyperthymic temperament//T. Affect Disord.,1992, Vol. 11, p. 205-206.
  30. Cassano GB, Jori MC., and AMIMAJOR Group. Efficasy and safety of amisulpride 50mg versus paroxetine 20mg in major depression: A randomized, double-blind, parallel group study//Int Clin Psychopharmacol, 2002, № 17, p. 27-32.
  31. Cipriani A, Pretty H, Hawton K, Geddes JR. Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: A systematic review of randomized trials//Am. J. Psychiatry., 2005, № 162, p. 1805-19.
  32. Cohn JB, Collins G, Ashbrook E, Wernicke JE A comparison of fluoxetine lmipranune and placebo in patients with bipolar depressive disorder//Int Clin Psychopharmacol., 1989, Vol. 4 (4), p. 313-22.
  33. Coryell W., Endicott J., Maser J. D. et al. Long term stability of polarity distinctions in the affective disorders//Am. J. Psychiatry, 1995, № 152, p. 385 -390.
  34. Daly JJ, Prudic J, Devanand DP, et al. ECT in bipolar and unipolar depression: differences in speed of response//Bipolar Disord, 2001, Vol. 3, № 2, p. 95-104.
  35. Davis LL, Bartolucci A, Petty F. Divalproex in the treatment of bipolar depression: a placebo-controlled study//J Affect Disord, 2005, Vol. 85 № 3, p. 259-66.
  36. De Wilde JE, Doogan DP. Fluvoxamine and chlorimipramine in endogenous depression//J Affect Disord., 1982, Vol. 4, № 3, p. 249-59.
  37. Ehnvall A., Agren H. Patterns of sensitization in the course of affective illness. A life-charting study of treatment-refractory depressed patients//! Affect Disord., 2002, Vol. 70., p. 67-75.
  38. Fountoulakis KN. An update of evidence-based treatment of bipolar depression: Where do we stand?//Curr Opin Psychiatry., 2010, № 23, p. 19-24.
  39. Frye M, Ketter ТА, Kimbrell ТА. et al. A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders//J. Clin. Psychopharmacol, 2000, № 20, p. 607-614.
  40. Frye MA, Ha K, Kanba S, Kato T, Ozerdem A, Vazquez G, Vieta E. International consensus group on depression prevention in bipolar disorder//J. Clin. Psychiatry. 2011, Vol. 72, № 10, p. 1295-310.
  41. Ghaemi SN, Miller CJ, Berv DA, Klugman J, Rosenquist KJ, Pies RW. Sensitivity and specificity of the Bipolar Spectrum Diagnostic Scale for detecting bipolar disorder//! Affect Disord., 2005, № 84, p. 273-277.
  42. Ghaemi SN, Wingo AP, Filkowski MA. Long-term antidepressant treatment in bipolar disorder: meta-analyses of benefits and risks//Acta Psychiatr Scand., 2008, № 118, p. 347-356.
  43. Gao K, Gajwani P, Elhaj O, Calabrese JR. Typical and atypical antipsychotics in bipolar depression//J. Clin. Psychiatry., 2005, Nov, Vol. 66, № 11, p. 1376-85.
  44. Geddes JR, Calabrese JR, Goodwin GM. Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials//Br. J. Psychiatry, 2009, Jan, Vol. 194, № 1, p. 4-9.
  45. Gelenberg A.J., KaneJ. M., Keller M.B. Comparison of standart and low serum levels of lithium for maintance treatment of bipolar disorders//N. Engl.J. Med., 1989, p. 1489-1493.
  46. Gijsman H.J. et al. Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled Trials//Am. J. Psychiatry, 2004,№ 161, p. 1537-1547.
  47. Goodwin F. K., Jamison K. Manic-Depressive Illness. New York: Oxford University Press, 1990.
  48. Goodwin GM. Consensus Group. Evidence-based guidelines for treating bipolar disorder: revised second edition — Recommendations from the British Association for Psychopharmacology//J Psychopharmacol., 2009, № 23, p. 346-388.
  49. Goren JL, Levin GM. Mania with bupropion: a dose-related phenomenon?//Ann Pharmacother, 2000, May, Vol. 34, № 5, p. 619-21.
  50. Goswami U, Basu S, Khastgir U et al. Neurobiological characterization of bipolar affective disorders: a focus on tardive dyskinesia and soft neurological signs in relation to serum dopamine Beta hydroxylase activity//Indian J Psychiatry, 1998, Vol. 40, № 3, p. 201-11.
  51. Grossman F, Potter WZ, Brown EA, Maislin G. A double-blind study comparing idazoxan and bupropion in bipolar depressed patients//J Affect Disord., 1999, Vol. 56 (2-3), p. 237-43.
  52. Grunze HC et al. World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Bipolar Disorders, Part I: Treatment of Bipolar Depression//World J Biol Psychiatry, 2002, № 3, p. 115 -124.
  53. Grunze HC. Quetiapine is effective in the treatment of adults in the acute phase of bipolar (lepression//Evid Based Ment Health., 2010, Vol. 13, № 3, p. 88.
  54. Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression//World J Biol Psychiatry, 2010, № 11, p. 81-109.
  55. Hantouch E.G, Akiskal H. S., Lancrenon S. et al. Systematic clinical methodology for validating bipolar II disorder//J. Affect. Disord, 1998, Vol. 50, p. 163-173.
  56. Himmelhoch JM, Fuchs CZ, Symons BJ. A double-blind study of tranylcypromine treatment of major anergic depression//J Nerv Ment Dis., 1982, Vol. 170,№ 10, p. 628-34.
  57. Himmelhoch JM, Thase ME, Mallinger AG, Houck P. Tranylcypromine versus imipramine in anergic bipolar depression//Am. J. Psychiatry, 1991, Vol. 148, № 7, p. 910-6.
  58. Hirschfeld R, 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, Vol. 157, p. 1873-1875.
  59. Hirschfeld R. M., Calabrese J. R., Weissman M. M. et al. Sreening for bipolar disorder in the community//J. Clin. Psychiatry, 2003 (b), Vol. 64, p. 53-59.
  60. Hirschfeld RMA, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: How far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder//J. Clin. Psychiatry, 2003, № 64, p. 161-74.
  61. Judd L. L., Akiskal H. S., Schettler P.J. et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder//Arch. Gen. Psychiatry, 2002, Jun; N° 59 (6), p. 530-537
  62. Kalinin VV. Suicidality and Antiepileptic Drugs: Is there a Link?//Drug Saf 2007, № 30 (2), p. 123-42.
  63. Ketter T. A, Calabrese J. R. Stabilization of mood from below versus above baseline in bipolar disorder: a new nomenclature//J. Clin. Psychiatry, 2002, № 63, p. 146-151.
  64. Lambert PA. Acute and prophylactic therapies of patients with affective disorders using valpromide (dypropylaetamide). In: Anticonvulsants in affective disorders Edited by HE Emrich, T Okuma, AA Muller. Elsevier Science Publishers, Amsterdam, Oxford, Princeton, 1984.
  65. Malhi GS, Mitchell PB, Salim S. Bipolar depression: management options//CNS Drugs, 2003, № 17 (1), p. 9-25.
  66. McElroy SL, Weisler RH, Chang W, Olausson B, Paulsson B, Brecher M, Agambaram V, Merideth C, Nordenhem A, Young AH. A double-blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II)//J. Clin. Psychiatry., 2010, Vol. 71, №2, p. 163-74.
  67. McIntyre R. S., Mancini D. A., McCann S., et al. Topiramate versus bupropion SR when added to mood-stabilizer therapy for the depressive phase of bipolar disorder: a preliminary singleblind study//Bipolar Disord., 2002, Vol. 4, N° 3, p. 207-213.
  68. Miller-Siecheneder F, Miller MJ, Hillert A, Szegedu A, Wetzel H, Benkert O. Risperidone versus haloperidol in the treatment of patients with a combined psychotic and depressive syndrome//J. Clin. Psychopharmacol, 1998, № 18, p. 111-120.
  69. Mendlewicz J, Youdim MB. Antidepressant potentiation of 5-hydroxytryptophan by L-deprenil in affective illness//J Affect Disord., 1980, Vol. 2, № 2,137-46.
  70. Mitchell PB, Wilhelm K, Parker G, et al. The clinical features of bipolar depression: a comparison with matched major depressive disorder patients//J. Clin. Psychiatry, 2001, Vol. 62, №3, p. 212-6.
  71. Mӧller H.J., Do recent efficacy data on the drug treatment of acute bipolar depression support the position that drugs other than antidepressants are the treatment of choice?//Eur Arch Psy Clin Neurosci, 2006, Vol. 256, p. 1-16.
  72. Montgomery S. A. The advantages of paroxetine in different subgroups of depression//Int. Clin. Psychopharmacol., 1992, Vol. 6 (suppl. 4), p. 91-100.
  73. Nemeroff CB et al. Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression//Am. J. Psychiatry, 2001, № 158, p. 906-912.
  74. Parker G, Parker K, Mitchell P, Wilhelm K. Atypical depression: Australian and US studies in accord//Curr Opin Psychiatry., 2005, № 18 (1), p. 1-5.
  75. Post R. M. Transduction of psychological stress into the neurobiology of recurrent affective disorder//Am. J.. Psychiatry, 1992, Vol. 149, p. 999-1010.
  76. Post RM. et al. Alternative approaches to refractory depression in bipolar illness//Depress Anxiety, 1997, № 5, p. 175-189.
  77. Post R. M. Denicoff K. D., Leverich G. S. Altshuler L. L. et al. Presentation of depression in bipolar illness//Clinical neuroscience Research, 2002, № 2, p. 142-157.
  78. Post RM, Altshuler LL, Leverich GS, Frye MA, et al Mood switch in bipolar depression-comparison of adjunctive venlafaxine, bupropion and sertraline//Br. J. Psychiatry., 2006, № 189, p. 124-31.
  79. Potter WZ. Bipolar depression: specific treatments//J. Clin. Psychiatry, 1998, Vol. 59, suppl. 18, p. 30-6.
  80. Prien R. F., Klett C.J., Caffey E. M. Lithium carbonate and imipramine in the prevention of affective episodes//Arch. Gen. Psychiatry., 1973, Vol. 29, p. 420-425.
  81. Prudic J, Sackeim H, Devanand DP. Medication resistance and clinical response to ECT//Psychiatry Res, 1990, № 31, p. 287-96.
  82. Rapaport MN, Canuso CM, Rouillon F, Leblanc J, Young AH, Loesher A, Roy-Byrne P, Post R. M., Uhde T. W., et al. The longitudinal course of recurrent affective illness: life chart data from research patients at the NIMH//Acta. Psychiatr. Scand., 1985, Vol. 317, p. 1-34.
  83. Rapaport MH, Gharabawi GM, Canuso CM et al. Effects of risperidone augmentation in patients with treatment-resistant depression: Results of open-label treatment followed by doubleblind continuation//Neuropsychopharmacology, 2006, Vol. 31,№ 11, p. 2505-13.
  84. Sachs G. S., Lafer B., Stoll A. L., Banou M., Triboult A. B., Tohen M., Rosenbaum J. F. A double-blind trial of bupropion versus desipramine for bipolar depression//!. Clin. Psychiatry., 1994, Vol. 55, p. 391-393.
  85. Sachs GS, Ghaemi SN. Safety and efficacy of risperidone versus placebo in combination with lithium or valproate in the treatment phase of bipolar disorder//Int J Neuropsychopharmacol, 2000, Vol. 3 (suppl. 1): p. 143.
  86. Sachs GS, Altshuler LL, Ketter ТА, et al. Divalproex versus placebo for the treatment of bipolar depression//American College of Neuropsychopharmacology., 2001, Abstracts.
  87. Sachs G. Managing bipolar affective disorder. London, Science Press, 2004,146 p.
  88. Sachs GS. Strategies for improving treatment of bipolar disorder: integration of measurement and management//Acta Psychiatr Scand Suppl., 2004, Vol. 422, p. 7-17.
  89. Sachs GS, Nierenberg A A, Calabrese JR. Effectiveness of adjunctive antidepressant treatment for bipolar depression//N EnglJ Med., 2007, Vol. 356, p. 1711-1722.
  90. Sachs G. Antidepressants may be useless in bipolar depression. 21st ECNP Congress, Barselona, Spain, 30Aug.-3Sep. 2008.
  91. Simon GE, Unutzer J. Health Care utilization and costs among patients treated for bipolar disorder in an insured population//Psychiatr Serv., 1999, № 50, p. 1303-8.
  92. Sidor MM, Macqueen GM. Antidepressants for the acute treatment of bipolar depression: a systematic review and meta-analysis//J. Clin. Psychiatry., 2011, Vol. 72, № 2, p. 156-67.
  93. Small JG. Anticonvulsants in affective disorders//Psychopharmacol Bull., 1990, № 26, p. 25-36.
  94. Silverstone T. Moclobemide vs. imipramine in bipolar depression: a multicentre double-blind clinical trial//Acta Psychiatr Scand., 2001,104 (2), p. 104-9.
  95. Smith LA, Cornelius VR, Azorin JM, Perugi G, Vieta E, Young All, et al. Valproate for the treatment of acute bipolar depression: Systematic review and meta-analysis//J Affect Disord. 2010, № 122, p. 1-9.
  96. Smith DJ, Griffiths E, Kelly M, Hood K, Craddock N et al. Unrecognised bipolar disorder in primary care patients with depression//Br. J. Psychiatry., 2011, Vol. 199, p. 49-56.
  97. Strejilevich SA, Martino DJ, Marengo E, Igoa A, Fassi G, Whitham EA, Ghaemi SN. Longterm worsening of bipolar disorder related with frequency of antidepressant exposure//Ann Clin Psychiatry., 2011, Vol. 23, № 3, p. 186-92.
  98. Suppes T, Kelly DI, Perla JM. Challenges in the management of bipolar depression//J. Clin. Psychiatry, 2005, Vol. 66 (suppl. 5), p. 11-16.
  99. The Expert Consensus Guideline Series. Treatment of bipolar disorder. Steering Committee: Allen Frances, John P. Docherty, David A. Kahn//The Journal of Clinical Psychiatry., 1996, Vol. 57, suppl. 12A.
  100. 100.Tohen M, Vieta E, Calabrese JR et al. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar depression//Arch. Gen. Psychiatry, 2003, № 60, p. 1079-1088.
  101. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy//N Engl J Med., 2008, Vol. 358, p. 252-260.
  102. Van der Loos ML, Mulder PG, Hartong EG, Blom MB, Vergouwen AC, de Keyzer HJ, et al. Efficacy and safety of lamotrigine as add-on treatment to lithium in bipolar depression: A multicenter, double-blind, placebo-controlled trial//J. Clin. Psychiatry., 2009, Vol. 70, p. 223-31.
  103. Vieta E. Managing Bipolar Disorder in Clinical Practice. Published by Current medicine group Ltd, Porters South, London, UK, 2006.
  104. Wehr T. A., Goodwin F. K. Can antidepressants cause mania and worsen the course of affective illness?//Am.J. Psychiatry, 1987, Vol. 144, p. 1403-1411.
  105. Winsberg ME, DeGolia SG, Strong CM, et al. Divalproex therapy in medication-naive and mood-stabilizer-naive bipolar II depression//J Affect Disord, 2001, Vol. 67 (1-3), p. 207-12.
  106. 106.Wolff N, Perlick DA, Kaczynski R, Calabrese J, Nierenberg A, Miklowitz DJ. Modeling costs and burden of informal caregiving for persons with bipolar disorder//J Ment Health Policy Econ., 2006, № 9, p. 99-110.
  107. Yatham LN, Kennedy SH, Schaffer A, Parikh SV, Beaulieu S, O’Donovan C, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: Update 2009//Bipolar Disord., 2009, Vol. 11, p. 225-55.
  108. Young LT, Joffe RT, Robb JC, MacQueen GM, Marriott M, Patelis-Siotis I. Double-blind comparison of addition of a second mood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression//Am. J. Psychiatry, 2000, Vol. 157, p. 124-6.
  109. Young AH, McElroy SL, Bauer M, Philips N, Chang W, Olausson B, et al. A double-blind, placebo-controlled study of quetiapine and lithium monotherapy in adults in the acute phase of bipolar depression (EMBOLDEN I)//J. Clin. Psychiatry, 2010, Vol. 71, p. 150-62.

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