Case Clinic Challenge: A 24-Year-Old Man With Bipolar Depression and Suicidal Ideation

Evidence-Based Therapies for Bipolar Depression: Making Informed Treatment Decisions
0.5 AMA PRA Category 1 Credit(s)
Launch Date:
December 21, 2015
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Psychiatrists, nurse practitioners, physician assistants, and other healthcare professionals working in a specialty setting who manage patients with bipolar depression.

Relevant Terms:


Andrew A. Nierenberg, MD

Andrew A. Nierenberg, MD
Thomas P. Hackett, MD, Endowed Chair in Psychiatry
Director, MGH Bipolar Clinic and Research Program
Director, Training and Education, MGH Research Institute
Associate Director, Depression Clinical and Research Program
Massachusetts General Hospital
Professor of Psychiatry, Harvard Medical School
Boston, MA

Andrew A. Nierenberg, MD 
Director, Bipolar Clinic and Research Program
Massachusetts General Hospital
Boston, MA
1. Construct individualized, evidence-based treatment plans for patients with bipolar I depression, assessing the data for approved and nonapproved therapies
2. Employ strategies for a patient-centric approach and more effective patient/caregiver communication with regard to treatment options, adherence, and improving outcomes and quality of life

Provided by Haymarket Medical Education
Supported by an educational grant from Sunovion Pharmaceuticals Inc.
Program Description  
Patients with bipolar disorder spend more time in depression than mania or hypomania and tend to seek treatment during depressive episodes more often than during manic periods. There is often a discrepancy between real-world management of bipolar depression and evidence-based recommendations. Treating patients with bipolar depression ideally requires a partnership between the patient and the clinician, including shared decision-making. This interactive case highlights data-supported treatment options and effective patient dialogues that can help identify and respond to the patient’s individual needs and improve outcomes for bipolar depression. 
Disclosure of Conflicts of Interest Statement
In accordance with the ACCME Standards for Commercial Support, Haymarket Medical Education requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. Disclosures are as follows:
Andrew A. Nierenberg, MD:
Abbott Laboratories, American Psychiatric Association, Appliance Computing Inc. (Mindsite), Basilea, Brain Cells, Inc., Brandeis University, Bristol-Myers Squibb, Clintara, Corcept, Dey Pharmaceuticals, Dainippon Sumitomo (now Sunovion), Eli Lilly and Company, EpiQ, L.P./Mylan Inc., Forest, Genaissance, Genentech, GlaxoSmithKline, Healthcare Global Village, Hoffman LaRoche, Infomedic, Lundbeck, Janssen Pharmaceutica, Jazz Pharmaceuticals, Medavante, Merck, Methylation Sciences, Naurex, Novartis, PamLabs, Parexel, Pfizer, PGx Health, Otsuka, Ridge Diagnostics, Shire, Schering-Plough, Somerset, Sunovion, Takeda Pharmaceuticals, Targacept, and Teva; consulted through the MGH Clinical Trials Network and Institute (CTNI) for AstraZeneca, Brain Cells, Inc., Dainippon Sumitomo/Sepracor, Johnson and Johnson, Labopharm, Merck, Methylation Science, Novartis, PGx Health, Shire, Schering-Plough, Targacept, and Takeda/Lundbeck Pharmaceuticals.
Grants/Research Support:
American Foundation for Suicide Prevention, AHRQ, Brain and Behavior Research Foundation, Bristol-Myers Squibb, Cederroth, Cephalon, Cyberonics, Elan, Eli Lilly and Company, Forest, GlaxoSmithKline, Janssen Pharmaceutica, Lichtwer Pharma, Marriott Foundation, Mylan, NIMH, PamLabs, PCORI, Pfizer Pharmaceuticals, Shire, Stanley Foundation, Takeda, and Wyeth-Ayerst.
Appliance Computing, Inc. (MindSite); Brain Cells, Inc., Medavante.
Clinical Positive Affect Scale and the MGH Structured Clinical Interview for the Montgomery-Asberg Depression Scale exclusively licensed to the MGH Clinical Trials Network and Institute (CTNI).
The staff, planners, and reviewer at Haymarket Medical Education have no relevant financial relationships to disclose.

Accreditation/Designation of Credit Statement
Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Haymarket Medical Education designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only those credits commensurate with the extent of their participation in the activity.
Disclosure of Unlabeled Use
This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. Sunovion Pharmaceuticals Inc. and HME do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Sunovion Pharmaceuticals Inc. and HME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Method of Participation 
To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/Exam History, which you can access at any time.

Contact Information
If you have any questions relating to the accreditation of this activity, please contact Julie A. Tagliareni at 

Privacy Policy
Supported Browsers:
Internet Explorer 9.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6+ for Mac OSX 10.7 and above