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Dehning J, Grunze H, Hausmann A. Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report. Clin Pract Epidemiol Ment Health. 2017;13:43-48doi: 10.2174/1745017901713010043.
Dehning, J., Grunze, H., & Hausmann, A. (2017). Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report. Clinical practice and epidemiology in mental health : CP & EMH, 1343-48. https://doi.org/10.2174/1745017901713010043
Dehning, Julia, et al. "Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report." Clinical practice and epidemiology in mental health : CP & EMH vol. 13 (2017): 43-48. doi: https://doi.org/10.2174/1745017901713010043
Dehning J, Grunze H, Hausmann A. Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report. Clin Pract Epidemiol Ment Health. 2017 May 31;13:43-48. doi: 10.2174/1745017901713010043. eCollection 2017. PMID: 28659991; PMCID: PMC5470062.
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Clin Pract Epidemiol Ment Health. 2017 May 31;13:43-48. doi: 10.2174/1745017901713010043. eCollection 2017.

Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report.

Clinical practice and epidemiology in mental health : CP & EMH

Julia Dehning, Heinz Grunze, Armand Hausmann

Affiliations

  1. Department of Medicine, Paracelsus Medical University, Salzburg, Austria.
  2. Department of Medicine, Medical University - Psychiatry, Innsbruck, Austria.

PMID: 28659991 PMCID: PMC5470062 DOI: 10.2174/1745017901713010043

Abstract

BACKGROUND: The optimal duration of antidepressant treatment in bipolar depression appears to be controversial due to a lack of quality evidence, and guideline recommendations are either vague or contradictive. This is especially true for second line treatments such as bupropion that had not been subject to rigourous long term studies in Bipolar Disorder.

CASE PRESENTATION: We report the case of a 75 year old woman who presented with treatment refractory bipolar depression. Because of insufficient response to previous mood stabilizer treatment and refractory depressive symptoms, bupropion was added to venlafaxine and lamotrigine. From there onwards, the patient improved continuously without experiencing deterioration of depression or a switch into hypomania. Our patient being on antidepressants for allmost four years experienced an obvious benefit from longterm antidepressant administration.

CONCLUSION: Noradrenergic/dopaminergic mechanisms of action may play a more prominent role in bipolar depression, and may still be underused as a therapeutic strategy in the acute phase as well as in long-term maintenance in at least a subgroup of bipolar patients. There is still a lack of evidence from RCTs, but this case report further supports antidepressant long-term continuation and the usefulness of a noradrenergic/dopaminergic antidepressant in the acute and maintenance treatment of bipolar disorder.

Keywords: Bipolar disorder; Bupropion; Depression; Guidelines; Maintenance treatment; TEAS

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