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Correspondence
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Volume 357:614-616 August 9, 2007 Number 6
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Adjunctive Antidepressant Treatment for Bipolar Depression

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by Belmaker, R.H.
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by Sachs, G. S.
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To the Editor: Sachs et al. (April 26 issue)1 report that adding an adjunctive antidepressant drug offers no benefit over continued mood-stabilizer monotherapy in the treatment of bipolar depression. This finding contradicts some previous studies and the experience of many clinicians. In his thoughtful accompanying editorial, Belmaker2 identifies possible reasons for this discrepancy, including diagnostic heterogeneity and changes in the manifestation of bipolar disorder during the past 20 years. These observations are perhaps too circumspect.

The past two decades have seen a marked increase in the diagnosis of bipolar disorder by North American psychiatrists.3 This trend has many origins: a . . . [Full Text of this Article]



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