BALANCE 2: A randomised controlled trial of treatments for recovery in bipolar depression
Ly-Mee Yu and Ed Juszczak with John Geddes and Guy Goodwin (Oxford)
There is lack of reliable evidence to inform treatment of recovery in bipolar disorder. The main current strategies are to use treatments that are effective in unipolar depressive disorder or treatments that are believed to stabilise mood and prevent relapse. Antidepressants may be an effective treatment for bipolar disorder but they increase the risk of 'switching' to mania and rapid cycling. Although SSRIs may induce little or no switching in the short-term, the fear remains that all antidepressants may precipitate manic episodes or rapid cycling in the medium or longer term.
BALANCE 2 is a randomised trial to address the key question of whether, for patients with bipolar depression, SSRI-type antidepressants are more effective at reducing depressive symptoms in the short-term, but more likely to induce mood instability in the longer term, than is a mood stabiliser. Target sample size is 500; recruitment start-up phase commenced in November 2004
