From the Guidelines
Bipolar II disorder treatment options are primarily focused on managing symptoms and preventing relapse, with a combination of medications and psychosocial therapies being the most effective approach.
Medication Options
- Mood stabilizers: Lithium, valproate, and lamotrigine are commonly used to treat bipolar II disorder, with lithium being the only FDA-approved medication for bipolar disorder in youths aged 12 and older 1.
- Antipsychotics: Olanzapine, risperidone, quetiapine, and ziprasidone are approved for acute mania in adults, and may be used off-label for bipolar II disorder in children and adolescents 1.
- Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) may be used to treat depressive symptoms, but with caution due to the risk of inducing manic episodes 1.
Psychosocial Therapies
- Psychoeducational therapy: Educating patients and families about the disorder, treatment options, and relapse prevention strategies is essential 1.
- Family-focused therapy: Stressing the importance of treatment compliance, positive family relationships, and problem-solving skills can help reduce relapse rates and improve symptoms 1.
- Interpersonal and social rhythm therapy: Focusing on reducing stress and vulnerability by stabilizing social and sleep routines can help decrease relapse and lessen depressive symptoms 1.
- Cognitive-behavioral therapy: Individual and family-based cognitive-behavioral therapy can help address psychological development, skill building, and symptom monitoring 1.
Treatment Approach
- A comprehensive, multimodal treatment approach that combines psychopharmacology with adjunctive psychosocial therapies is almost always indicated for early-onset bipolar disorder 1.
- Maintenance therapy is often needed for youths with bipolar disorder, with some individuals needing lifelong therapy when the benefits of continued treatment outweigh the risks 1.
- Regular follow-up assessments and a strong therapeutic relationship are crucial in maintaining compliance and preventing relapse 1.
From the Research
Treatment Options for Bipolar II Disorder
The treatment options for Bipolar II disorder are varied and can be categorized into several types, including:
- Pharmacological treatments, such as mood-stabilizing agents and antipsychotics
- Psychotherapy, including interpersonal and social rhythm therapy (IPSRT)
Pharmacological Treatments
Pharmacological treatments for Bipolar II disorder include:
- Mood-stabilizing agents, such as lithium and valproate, which have been shown to be effective in treating hypomania and preventing depressive episodes 2, 3, 4
- Antipsychotics, such as quetiapine, olanzapine, and risperidone, which have been shown to be effective in treating hypomania and depressive episodes 2, 3, 4
- Antidepressants, which may be used to treat depressive episodes, but their use is controversial and requires careful consideration due to the risk of inducing hypomania or mania 2, 3, 5
Psychotherapy
Psychotherapy, including IPSRT, has been shown to be effective in treating Bipolar II disorder, particularly in improving interpersonal and social functioning 6
Specific Treatment Approaches
Specific treatment approaches for Bipolar II disorder include:
- Quetiapine, which has been shown to be effective in treating depressive episodes and preventing relapse 3, 5
- Lamotrigine, which has been shown to be effective in delaying depressive recurrences, but its use requires careful consideration due to the risk of side effects 2, 3
- Lithium, which has been shown to be effective in preventing depressive and hypomanic episodes, and is considered a first-line treatment for Bipolar II disorder 2, 3, 4