Treat bipolar depression with atypical antipsychotics and mood stabilisers; new therapies require further study

Patients with bipolar disorder frequently suffer from episodes of depression, which is a major cause of morbidity. A range of atypical antipsychotics and mood stabilisers are recommended in guidelines for the treatment of bipolar depression but there is no consensus on which therapies should be used in the first line. Many patients remain symptomatic and experience relapse despite treatment. Pharmacotherapies with efficacy in other depressive disorders and those with novel mechanisms of action (including those targeting neuronal plasticity, inflammation, mitochondrial function) are currently being investigated for efficacy in bipolar depression.