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Bipolar Depression - Clinical Management in the Community

neuroscienceCME Chart Review

Premiere Date: Wednesday, June 26, 2013

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Pharmacists (ACPE)
  4. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Creditâ„¢

Credit Expiration Date:
Sunday, June 26, 2016
Note: Credit Is No Longer Available



Charles B. Nemeroff, MD, PhDCharles B. Nemeroff, MD, PhD (Moderator)
Leonard M. Miller Professor and Chairman
Department of Psychiatry and Behavioral Sciences
Clinical Director, Center on Aging
Chief of Psychiatry, Jackson Memorial Hospital
Chief of Psychiatry, University of Miami Hospital
Professor of Biochemistry and Molecular Biology
Leonard M. Miller School of Medicine
University of Miami
Miami, FL

Mark A. Frye, MDMark A. Frye, MD 
Professor and Chair, Department of Psychiatry and Psychology
Stephen & Shelly Jackson Family Professorship in Individualized Medicine
Director, Mayo Clinic Depression Center
Mayo Clinic
Rochester, MN

Statement of Need

An accurate diagnosis is, of course, the first step in making treatment decisions. Treatment choices in psychiatry are rarely straightforward, and bipolar depression is no exception to this general rule. Further, the number of FDA-approved medications for bipolar mania has tripled over the past decade, while the pharmacopoeia available for bipolar depression remains quite limited.(1)

Treating bipolar depression requires an individualized care plan. The construction of a care plan is further complicated by the limited number of FDA-approved medications. There are few reliable indicators of clinical efficacy to guide the treatment decisions; thus, each option should be discussed with the patient, including initiation and maintenance of therapy.(2) The final choice is often driven by which medication is likely to be best tolerated. In addition, psychotherapy has been shown to be an effective adjunctive treatment for bipolar depression.(1)

This neuroscienceCME Chart Review will highlight and critically review the current and emerging clinical treatment options for bipolar depression in a patient case that applies educational content in three related CME activities.

  1. Frye MA. Clinical practice. Bipolar disorder--a focus on depression. N Engl J Med. 2011;364(1):51-59. PMID: 21208108.
  2. Gitlin M, Frye MA. Maintenance therapies in bipolar disorders. Bipolar Disord. 2012;14(Suppl 2):51-65. PMID: 22510036.

Activity Goal

The goal of this activity is to review and illustrate to clinicians the various options for the clinical management of bipolar depression to improve outcomes.

Learning Objectives

At the end of this CE activity, participants should be able to:

  • Implement evidence-based pharmacological therapies for bipolar depression as part of an individualized treatment plan for patients.
  • Recommend nonpharmacological therapies as part of a treatment plan for patients with bipolar depression.

The following learning objectives pertain only to those requesting CNE or CPE credit:

  • Review the evidence-based therapies for bipolar depression.
  • Define the nonpharmacological therapies that have been effective in bipolar depression.

Financial Support

Supported by an educational grant from Sunovion Pharmaceuticals Inc.

Target Audience

Physicians, physician assistants, nurses, nurse practitioners, pharmacists, social workers, certified case managers, and other health care professionals who evaluate individuals for mood disorders.

Credit Information

CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Creditâ„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses):
Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hour.

CCMC Credit (Certified Case Managers):
This program has been approved for 1 hour by the Commission for Case Manager Certification (CCMC).

CPE Credit (Pharmacists):
ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hour (0.1 CEU)
Universal Activity Number: 0376-0000-14-012-H01-P (recorded programs)
Activity Type: knowledge-based

Post-tests, credit request forms, and activity evaluations must be completed online at (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Dr. Nemeroff has disclosed that he receives grants/research support from the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH). He serves as a consultant to Allergen, Inc.; Eli Lilly and Company; SK Pharma; Roche; Takeda Pharmaceuticals North America, Inc.; and Xhale, Inc. He serves on the scientific advisory boards of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); CeNeRx BioPharma; National Alliance for Research on Schizophrenia and Depression (NARSAD); PharmaNeuroBoost; Xhale, Inc.; Skyland Trail; and AstraZeneca Pharmaceuticals (2009). He serves on the board of directors of the American Foundation for Suicide Prevention (AFSP); Anxiety Disorders Association of America (ADAA); Gratitude America; Cook Pharma, Inc. (2010); NovaDel Pharma, Inc; and Skyland Trail. He is a stockholder of CeNeRx BioPharma; NovaDel Pharma, Inc., PharmaNeuroBoost; Reevax Pharmaceuticals LLC; and Xhale, Inc. His other financial Interests include CeNeRx BioPharma and PharmaNeuroBoost. He holds patents for the following: method and devices for transdermal delivery of lithium (US 6,375,990B1); method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (US 7,148,027B2).

Dr. Frye has disclosed that he received grant support from the Mayo Foundation for Medical Education and Research; Myriad Genetics; National Institute on Alcohol Abuse and Alcoholism (NIAAA); National Institute of Mental Health (NIMH); and Pfizer Inc. He serves as a consultant (unpaid) to Allergan; Myriad Genetics; Sunovion Pharmaceuticals Inc.; and Teva Pharmaceuticals. He has disclosed that he has received honoraria for CME Activities from CME Outfitters, LLC. He has received travel support from the Chilean Sociedad de Neurologia-Psiquiatria Y Neurocirugia; Advanced Health Media; GlaxoSmithKline;and Colombian Society of Neuropsycho-pharmacology.

Tony Graham, MD (content/peer reviewer) has no disclosures to report.

Nancy Jennings, MSN, MBA, MHA, RNC (content/peer reviewer) has no disclosures to report.

Robert Kennedy (planning committee) has no disclosures to report.

Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has no disclosures to report.

Sandra Haas Binford, MAEd (planning committee) has no disclosures to report.

Sharon Tordoff, CCMEP (planning committee) has no disclosures to report.

Unlabeled Use Disclosure

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

CME Outfitters, LLC, the faculty, and Sunovion Pharmaceuticals Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).


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