Antidepressants for Bipolar Disorder: Pro-Con-Debate
Registration Options
Activity Date: 04/19/2021
AAPP 2021 registration is closed.
Session Time and Location
The live session is complete.
Target Audience
This course is designed for pharmacists, nurse practitioners or other health care professionals involved in the comprehensive medication management of psychiatric and/or neurological patients.
Session Summary
There are many nuances to consider when evaluating the risks and benefits of antidepressant use in bipolar disorder (BD). Short-term efficacy of antidepressants for BD remains controversial and risks clinical worsening, especially in mixed states and with rapid-cycling. In this session, Drs. Goldberg and Nierenberg will debate the pros and cons of antidepressant use for BD treatment. Participants will hear evidence on both sides of the debate and gain insight to better equip them to make future treatment recommendations.
Course Requirements
To receive ACPE credit for the live session at the Annual Meeting, you must:
Sign in (or create a FREE account).
Register for this course.
Attend and participate in the entire session and reflect upon its teachings.
Complete the evaluation at the end of the activity.
Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.
Upon successful completion, ACPE credit is reported within 24 hours to CPE Monitor although transcripts can be retrieved by participants online in their ACPE Transcript.
AAPP has invested in supporting the most popular web browsers and leveraging software that our members use daily. Beyond PDF downloads, the rest of the system is built on HTML5, a technology that most up-to-date browsers will support. To access AAPP course materials online, you will need:
A modern web browser with JavaScript and cookies enabled: Chrome is strongly recommended,
or the latest version of Firefox or Safari.
A PDF reader: Chrome built-in, Firefox built-in, Acrobat
or FoxIt
An adequate device and Internet connection:
Processor: Dual-core 2Ghz or higher (Intel i3/i5/i7 or AMD equivalent);
Memory: 4 GB;
Storage: 5 GB available;
Internet speed: 4.0 Mbps (up/down)
AAPP web sites no longer fully support Microsoft Internet Explorer or Windows 8.1 and older. We cannot guarantee that the site will function perfectly on every device and configuration, but using the latest version of the software above will greatly improve your experience.
Joseph F. Goldberg, MD
Clinical Professor of Psychiatry
Icahn School of Medicine at Mount Sinai
New York, NY
Joseph F. Goldberg MD, MS is Clinical Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai in New York. Goldberg attended college at the University of Chicago, graduate school in neuroscience at the University of Illinois and Medical School at Northwestern University, followed by a psychiatry residency, chief residency, and psychopharmacology research fellowship at the Payne Whitney Clinic of New York Presbyterian Hospital. While serving on the faculty at Weill-Cornell Medical Center he was site principal investigator for the NIMH STEP-BD program. His research has focused on the clinical psychopharmacology of bipolar and other mood and psychotic disorders. He has received funding from NIMH, NARSAD, the American Foundation for Suicide Prevention, the Stanley Bipolar Research Foundation and industry, and is the author of over 200 peer-reviewed publications and four books, most recently, “Practical Psychopharmacology: Translating Findings From Evidence-Based Trials into Real World Clinical Practice” published by Cambridge University Press in 2020. He serves on the Board of Directors for the American Society of Clinical Psychopharmacology, is a Distinguished Fellow of the American Psychiatric Association, and for many years has been named by Castle Connolly as one of America’s Top Doctors.
Andrew Nierenberg, MD
Director of Dauten Family Center for Bipolar Treatment Innovation
Boston, MA
Andrew Nierenberg, MD, graduated from the Albert Einstein College of Medicine of Yeshiva University, Bronx, NY. After completing his residency in psychiatry at New York University/Bellevue Hospital, he studied clinical epidemiology at Yale University as a Robert Wood Johnson Clinical Scholar. Dr. Nierenberg then joined the faculty at Harvard Medical School, first at McLean Hospital in Belmont, Massachusetts and then at Massachusetts General Hospital, where he is currently Director of the Dauten Family Center for Bipolar Treatment Innovation, Associate Director of the Depression Clinical and Research Program, Director of Training and Education of the MGH Research Institute, Professor of Psychiatry at Harvard Medical School, and the Thomas P. Hackett, MD Endowed Chair in Psychiatry at MGH. He is also Honorary Professor in the School of Medicine, Faculty of Health at Deakin University, Geelong Australia.
Dr. Nierenberg’s primary interests are depression, bipolar depression, and novel treatments. Dr. Nierenberg has published over 475 papers and has been listed in The Best Doctors in America for the treatment of mood and anxiety disorders in every edition since 1994. From 2014 to 2017, he was listed among the World’s Most Influential Scientific Minds by Thompson Reuters in recognition of ranking among the top 1% of researchers for most cited papers in psychiatry worldwide.
Dr. Nierenberg and his colleagues developed an online research infrastructure called the MoodNetwork, a Patient-Powered Research Network (PPRN) that is part of the Patient-Centered Outcomes Research Institute (PCORI). The main aim of the MoodNetwork is to bring together patients, caregivers, and other stakeholders who are affected by mood disorders (i.e., Bipolar Disorder and Unipolar Depression) to form a cohort using patient-reported outcomes and electronical medical records as a national infrastructure for future studies and to participate in comparative-effectiveness studies. Additionally, he is currently the principal investigator for three Patient Centered Outcomes Research Institute (PCORI) projects that use MoodNetwork at a platform for research.
Faculty Disclosures
Grant/Research Support: Andrew Nierenberg: AFSP, AHRQ, BBRF, Bristol-Myers Squibb, Cederroth, Cyberonics, Forest Pharmaceuticals, GlaxoSmithKline, Janssen Pharmaceutica, Lichtwer Pharma, Eli Lilly, NARSAD, NIMH, PCORI, Pfizer, Shire, Stanley Foundation, Takeda, Wyeth-Ayerst
Speakers Bureau/Educational Services: Joseph Goldberg: Allergan, Intracellular Therapies, Otsuka, Sunovion
Financial: Joseph Goldberg: American Psychiatric Publishing, Cambridge University Press Royalties; Andrew Nierenberg: Honoraria: MGH Psychiatry Academy, ADURS, Brain and Behavior Foundation Colvin Prize, University of :Pisa, University of Wisconsin at Madison, University Texas Southwest at Dallas, Health New England and Harold Grinspoon Charitable Foundation and Eli Lilly and AstraZeneca, American Society for Clinical Psychopharmacology and Zucker Hillside Hospital and Forest and Janssen, Brandeis University, International Society for Bipolar Disorder, Dauten Family Center for Bipolar Treatment Innovation; Other Financial: MBL Publishing for past services as Editor-in-chief of CNS Spectrums; Slack Inc. for services as Editor of Psychiatric Annals; Associate Editor, Depression and Anxiety, Editorial Board, Mind Mood Memory, Belvior Publications; Patents/Copyrights: Copyright joint ownership with MGH for Structured Clinical Interview for MADRS and Clinical Positive Affect Scale
Presentation will include discussion of off-label, experimental, and/or investigational use of drugs or devices: (Goldberg) My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: antidepressants for bipolar disorder; lurasidone for major depressive disorder with mixed features; (Nierenberg) My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: antidepressants for bipolar disorder; lurasidone for major depressive disorder with mixed features
Affiliation: Andrew Nierenberg: Scientific Ad Board for Alkermes, Jazz Pharma, Sage Pharma, Otsuka, Neuronetics; Consulting for Acadia Pharma, Esai, Myriad, Sunovion, Neurostar, Merck, Giner, Protegenics
All relevant relationships have been mitigated.
Learning Objectives
Outline the benefits and risks of antidepressant utilization in the treatment of bipolar disorder.
Identify the risk of antidepressants to provoke treatment emergent affective switches in bipolar disorder and understand patient specific clinical characteristics that may influence antidepressant treatment outcomes.
Describe data supporting or refuting the safety and efficacy of antidepressant use in bipolar disorder based on key meta-analyses.
Discuss the strengths and limitations in the evidence base for antidepressants for bipolar disorder.
Continuing Education Credit and Disclosures
Activity Date: 04/19/2021 ACPE Contact Hours: 1 ACPE Number: 0284-0000-21-002-L01-P (Knowledge) Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.
The College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
AAPP owns the copyright, is licensed or has received permissions for use of, or is otherwise permitted to use copyrighted materials within any CPE activity. Authors and speakers are required to obtain necessary copyright permissions for content in CPE activities. AAPP complies with copyright laws and regulations.
Shari N. Allen, PharmD, BCPP
Assistant Professor
PCOM-SOP
Suwanee, GA
No Relevant Financial Relationships to Disclose
Jolene R. Bostwick, PharmD, BCPP, BCPS
Program Administrative Chair
Assistant Dean for Co-Curriculum and Professional Development & Clinical Professor
University of Michigan College of Pharmacy
Ann Arbor, MI
No Relevant Financial Relationships to Disclose
Bridget Bradley, PharmD, BCPP
Associate Professor
Pacific University School of Pharmacy
Hillsboro, OR
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: PSAP May 2021, Neurology and Psychiatry Book
Educational Grants, Research Grants or Contracts: NACDS Community Pharmacy Residency Grant
Lauren M. Brown, PharmD, BCPP
Clinical Pharmacy Specialist, Psychiatry
South Texas Veterans Health Care System
San Antonio, TX
No Relevant Financial Relationships to Disclose
Austin R. Campbell, PharmD, BCPP
Clinical Pharmacy Specialist - Psychiatry
University of Missouri Health Care
Columbia, MO
Financial Interests: Up To Date Contributor "Pharmacotherapy for schizophrenia: Long-acting injectable antipsychotic drugs"
Non-Financial Interests: Extension for Community Healthcare Outcomes, Show-Me ECHO Project
Chelsea N. Carr, PharmD, BCPP
Advanced Practice Pharmacist - Psychiatry
University of Maryland - Spring Grove Hospital Center
Catonsville, MD
No Relevant Financial Relationships to Disclose
Jordan Cooler, PharmD, BCPP
Clinical Assistant Professor
University of South Carolina College of Pharmacy
Columbia, SC
No Relevant Financial Relationships to Disclose
Amber R. Douglass, PharmD, BCPS, BCPP
Clinical Pharmacy Specialist - Mental Health
VA Tennessee Valley Healthcare System
Murfreesboro, TN
No Relevant Financial Relationships to Disclose
Kristen N. Gardner, PharmD, BCPP
Program Committee Chair
Clinical Pharmacy Specialist - Behavioral Health
Kaiser Permanente Colorado
Denver, CO
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Biostrategies - one time consultant re:LAIAs
Robert J. Haight, PharmD, BCPP
Clinical Pharmacist | Forensic Services
Saint Peter Regional Treatment Center (SPRTC), Minnesota Department of Human Services
Saint Peter, MN
No Relevant Financial Relationships to Disclose
Suzanne C. Harris, PharmD, BCPP
Clinical Assistant Professor/UNC Hospitals Region Experiential Director/Clinical Pharmacist Practitioner
UNC Eshelman School of Pharmacy
Chapel Hill, NC
Educational Grants, Research Grants or Contracts: North Carolina AHEC Campus Innovations Grants
Kayla D. Johnson, PharmD, BCPS, BCPP
Vanderbilt Psychiatric Hospital
Spring Hill, TN
No Relevant Financial Relationships to Disclose
Erin D. Knox, PharmD, BCPP
Pharmacy Education Specialist
UC Irvine Health
Orange, CA
No Relevant Financial Relationships to Disclose
Marketa Marvanova, PharmD, PhD, BCGP, BCPP, FASCP
Dean and Professor
University of Montana, Skaggs School of Pharmacy
Missoula, MT
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Editorial Board member: Continuum: Lifelong Learning in Neurology, consultant for Lexicomp as a clinical specialist in neurology and psychiatry
Educational Grants, Research Grants or Contracts: AACP/NABP: District V grant, Dakota Medical Foundation
Melissa Mitchell, PharmD, BCGP, BCPP, BCPS
Senior Clinical Pharmacist
RUHS MC
Moreno Valley , CA
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Neurocrine Speakers Bureau - Ingrezza, Janssen Speakers Bureau - Spravato
Thea R. Moore, PharmD, BCPP
Associate Professor
University of South Florida
Tampa, FL
Educational Grants, Research Grants or Contracts: Agency for Health Care Administration
Kristen Neumeister, PharmD, BCPP
Clinical Pharmacist- Mental Health
John Peter Smith Hospital
Fort Worth, TX
No Relevant Financial Relationships to Disclose
Melissa C. Palmer, PharmD, BCPP, BCPS
Clinical Assistant Professor
University of Missouri-Kansas City School of Pharmacy
Kansas City, MO
No Relevant Financial Relationships to Disclose
Lindsey Peters, PharmD, BCPS
Assistant Professor of Pharmacy Practice
Ohio Northern University
Ada, OH
No Relevant Financial Relationships to Disclose
Kristina Reinstatler, PharmD, BCPP, MBA
Clinical Pharmacy Specialist
UC Health University of Cincinnati Medical Center
Cincinnati, OH
No Relevant Financial Relationships to Disclose
Michael D. Shuman, PharmD, BCPP
Staff Pharmacist
Central State Hospital
Louisville, KY
No Relevant Financial Relationships to Disclose
Sheryl Thedford, PharmD, PhD, BCPS, BCPP
Clinical Psychiatric Pharmacist
University of Maryland, Spring Grove Hospital Center
Catonsville, MD
No Relevant Financial Relationships to Disclose
Taylor A. Thomas, PharmD, BCPP
Clinical Pharmacy Specialist- Mental Health
VA Northern Indiana Health Care System
Fort Wayne, IN
No Relevant Financial Relationships to Disclose
Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information and disclosures). The opinions expressed in the educational activity do not necessarily represent the views of AAPP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Presentation-Specific Disclosure: (Goldberg) My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: antidepressants for bipolar disorder; lurasidone for major depressive disorder with mixed features; (Nierenberg) My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: antidepressants for bipolar disorder; lurasidone for major depressive disorder with mixed features
It is the policy of AAPP to ensure independence, balance, objectivity, scientific rigor, and integrity in continuing education activities. Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer’s package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Fair balance is achieved through ongoing and thorough review of all materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by AAPP for any product or manufacturer identified.
AAPP websites use cookies to personalize and enhance your experience.
By continuing to use the site, you agree to this collection.
Learn more.
System Update:
We are undergoing major upgrades right now, and we appreciate your patience.
If you need help, please use the support chat or email info@aapp.org.
Learn more.