How to treat bipolar II depression and bipolar II mixed depression? – A reply to Benazzi

Abstract

I have read with interest the letter by Dr Benazzi who raises a significant public-health concern in response to our recent publication that highlighted the dearth of placebo-controlled trials in bipolar I disorder (Muzina and Calabrese, 2003). Dr Benazzi appropriately draws our attention to an even greater unmet need, which is the current state of research that informs the treatment of bipolar II disorder. Whereas it is accurate to describe the literature in bipolar I depression as being terribly inadequate given the morbidity and mortality associated with bipolar I disorder, the literature regarding the treatment of bipolar II disorder is considerably worse. In fact, there are no treatments approved for use in bipolar II disorder by the US Food and Drug Administration despite its higher prevalence.