Strategies for Improving Randomized Trial Evidence for Treatment of Bipolar Disorder

Treatment of bipolar disorder involves acute and maintenance phases with special considerations for manic and depressive episodes. As such, accumulated randomized controlled trials (RCTs) based evidence for treatment options of acute bipolar depression, mania, or maintenance phases require independent considerations. This chapter reviews methodological obstacles that are impeding progress in the development of therapeutic strategies for treatment of this serious illness and recommends strategies aimed at aiding improvement of future trials. Challenges encountered in design and conduct of the RCTs of bipolar depression, mania, and prophylaxis are considered independently. In each of these trial sets, limitations of existing evidence and strategies for their improvement are discussed.<br/>