Question

A 42-year-old woman with a history of bipolar I disorder presents with depressive symptoms. She has previously had mania when treated with antidepressant monotherapy. According to CANMAT bipolar guidelines, what is the most appropriate pharmacologic approach?

Accepted Answer

Initiate or optimise a mood stabiliser (e.g., lithium, lamotrigine) and consider adjunctive antidepressant only under specialist guidance

Answer

Start SSRI monotherapy

Answer

Use antidepressant monotherapy with careful monitoring

Answer

Avoid pharmacologic treatment and use psychotherapy alone

Answer

Use short-term benzodiazepines as primary treatment

Practice question

A 42-year-old woman with a history of bipolar I disorder presents with depressive symptoms. She has previously had mania when treated with antidepressant monotherapy. According to CANMAT bipolar guidelines, what is the most appropriate pharmacologic approach?