Diagnosis and Pharmacotherapy of Bipolar Depression in Adults

Approximately 60% of patients with bipolar disorder (BD) who present with depression are misdiagnosed as having recurrent unipolar depression, which may lead to inappropriate treatment and potential worsening of symptoms. Several factors may interfere with a positive screen and an accurate BD diagnosis—especially substance use disorders. By facilitating effective communication with patients, implementing diagnostic criteria, and using assessment tools, clinicians can accurately identify the often subtle indicators of the disorder and recommend individualized treatment. Whichever pharmacologic is prescribed, it is important to tailor treatment for patients with BD by considering the disease course, potential adverse effects, and comorbidities.