ABSTRACT
Bipolar disorder (BD) is a chronic disease with recurrent episodes of mania and depression. There is urgent need for rapid, effective, and safe treatments for bipolar depression which is difficult to treat using the current standard METHODS. Triple chronotherapy is a combination of sleep deprivation, sleep phase shift, and bright light therapy which has been shown to induce accelerated and sustained remissions in bipolar depression. In this report, we present a case of bipolar depression undergoing triple chronotherapy in addition to the standard treatment and discuss the importance of getting fast and sustained response in these cases.
Subject(s)
Bipolar Disorder/therapy , Chronotherapy/methods , Bipolar Disorder/psychology , Humans , Male , Middle AgedABSTRACT
Bupropion is a selective norepinephrine and dopamine reuptakeinhibitor. It is used in the treatment of depression and nicotineaddiction. When compared to the other antidepressants, bupropion hasa relatively lower risk of triggering shift to hypomania or mania in bipolardepression treatment. Here we report two cases of bipolar depressionpatients with manic shift when bupropion was used as an adjunct tomood stabilizer treatment. The first was a 43-year old female patient.Manic symptoms occurred after bupropion was added to lithium andquetiapine treatment for bipolar disorder (BD) depressive episode.Her manic symptoms regressed rapidly after discontinuing bupropiontreatment. The second patient was a 26-year old male on lithium andvalproate therapy with a BD diagnosis. After bupropion was added tohis treatment for depressive symptoms, psychotic mania ensued and hehad to be admitted to the hospital. Significant improvement was notedshortly after bupropion was discontinued and antipsychotic treatmentwas initiated.
