CS01 – Bipolar I Disorder in 2022: What Can We Do Differently to Optimize Identification and Management?

CS01 – Bipolar I Disorder in 2022: What Can We Do Differently to Optimize Identification and Management?

Friday, Oct. 28
12:00 – 13:30 (1.5 hrs)
Meeting Room: Grand Ballroom (Lower Concourse)
Lakshmi Yatham*, MBBS, FRCPC, MRCPsych; Andrea Bardell, MD, MSc, FRCPC; Ayal Schaffer, MD, FRCPC

CanMEDS Roles

  1. Medical Expert
  2. Health Advocate
  3. Scholar

At the end of this session, participants will be able to: 1) Identify patient characteristics, signs and symptoms to distinguish between major depressive disorder and bipolar I depression; 2) Describe optimal management modalities for individuals with BP I depression, including non-pharmacologic and novel pharmacologic strategies; and 3) Identify methods to optimize adherence to all interventions for bipolar I depression.

In bipolar I disorder (BP I), depressive episodes are markedly more frequent than manic episodes. As such, identification and management of depressive episodes of BP I is of paramount importance.

In this interactive symposium, the faculty will discuss methods to help distinguish between major depressive disorder (MDD) and BP I depression, including differential red flags in the history and the use of screening tools.

With respect to management, since the most recent guidelines were developed, there have been additional important developments with respect to pharmacotherapy. Cariprazine, a novel dopamine D3 and D2 partial agonist with preferential affinity for D3, has demonstrated efficacy across several clinical trials in acute BP I depression. Lumateperone, which has dopaminergic, serotonergic, and NMDA-receptor mediated glutaminergic activity, has also demonstrated efficacy in acute depression associated with BP I or II. The faculty will provide a brief overview of each of these therapies and discuss several other investigational pharmacologic approaches to the treatment of bipolar depression.

In terms of non-pharmacologic approaches to BP I, one of the key goals of management is suicide prevention. The faculty will explain the rationale for a shifting away from an exclusive focus on high-risk groups towards universal delivery of suicide prevention interventions.

The symposium will conclude with a discussion of personalized medicine for BP I depression, incorporating clinical judgment, relevant scientific evidence and clinical judgement to select the right intervention(s) for the right patient at the right time.