Augmentation of antidepressants with antipsychotics has become a common practice, and aripiprazole (Abilify) has been FDA-approved at doses from 2 mg/day to 15 mg/day for this purpose. In a recent report, 225 patients with major depressive disorder (MDD) who had failed one to four antidepressant trials were studied to determine whether low dose Abilify really works.
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A 32-year-old pregnant woman with bipolar disorder, well-controlled on valproic acid (Depakote), comes into your office wanting advice on medications. What do you do?
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Whether you work in a hospital or an office setting, you’ve probably seen many patients who come to you with a “history of bipolar disorder.” We’ve seen it, too, in multiple settings at an academic medical center. Is this a new epidemic? Or a redefinition of what it means to be “bipolar”?
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Why should we as psychiatrists focus on the psychosocial aspects of bipolar disorder? Dr. Miklowitz explores the benefits of a treatment program that combines targeted psychosocial treatments and medication.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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