Lithium for bipolar depression with chronic pain

抄録

Chronic pain complaints are common among patients with major depression, and patients with physical pain are more likely to develop major depression. Antidepressants are effective against both pain and the symptoms of depression, but the use of these agents for treating patients with bipolar disorder is problematic because of the significant risk of inducing mania. In the present case, a patient with bipolar depression suffering from chronic pain had been misdiagnosed with major depressive disorder and treated with antidepressants for several years. His pain improved dramatically after the administration of lithium, and he remained free of pain despite the discontinuation of treatment with antidepressants. This suggests that lithium might be more useful than antidepressants for the treatment of bipolar depression with chronic pain. Further research is needed to compare the effectiveness of lithium to that of other mood stabilizers such as valproate, carbamazepine, and lamotrigine in order to identify treatment strategies for patients with bipolar disorder associated with chronic pain.