HAS has received honoraria for CME presentations from AstraZeneca and Bristol-Myers Squibb; has served as a member of the speakers bureau for Bristol-Myers Squibb; and has served as a consultant to Novartis. EF has received grant support from Forest Research Institute and royalties from Guilford Press; has served as a consultant to and advisory board member for Eli Lilly & Co., Servier, and Novartis; and has served as a consultant to Pfizer. DRF, DN and PH have no competing interests to report.
Psychotherapy as monotherapy for the treatment of bipolar II depression: a proof of concept study
Version of Record online: 9 JAN 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard
Volume 11, Issue 1, pages 89–94, February 2009
How to Cite
Swartz, H. A., Frank, E., Frankel, D. R., Novick, D. and Houck, P. (2009), Psychotherapy as monotherapy for the treatment of bipolar II depression: a proof of concept study. Bipolar Disorders, 11: 89–94. doi: 10.1111/j.1399-5618.2008.00629.x
- Issue online: 9 JAN 2009
- Version of Record online: 9 JAN 2009
- Received 22 October 2007, revised and accepted for publication 28 March 2008
- affective disorder;
- bipolar disorder;
- interpersonal psychotherapy;
Objectives: We conducted a proof of concept study to determine the feasibility of using an individual psychotherapy, Interpersonal and Social Rhythm Therapy (IPSRT), as monotherapy for the acute treatment of bipolar II depression.
Methods: Unmedicated individuals (n = 17) meeting DSM-IV criteria for bipolar II disorder and currently depressed received weekly psychotherapy (IPSRT) for 12 weeks. After 12 weeks of acute treatment, individuals received an additional 8 weeks of follow-up treatment consisting of continued weekly IPSRT with supplementary lamotrogine for IPSRT non-responders.
Results: By week 12, 41% (n = 7) of the sample responded to IPSRT monotherapy (defined as ≥50% reduction in depression scores without an increase in mania scores), 41% (n = 7) dropped out of or were removed from the study, and 18% (n = 3) did not respond to treatment. By week 20, 53% (n = 9) had achieved a response and 29% (n = 5) achieved a full remission of symptoms.
Conclusions: Interpersonal and Social Rhythm Therapy appears to be a promising intervention for a subset of individuals with bipolar II depression. A randomized controlled trial is needed to systematically evaluate the efficacy of IPSRT as an acute monotherapy for bipolar II depression.