The Systematic Treatment Enhancement Program for Bipolar Disorder was designed to determine the most effective somatic and psychosomatic interactive strategies to treat bipolar disorder. This program was based on consensus practice guidelines that outline clinical treatments for bipolar disorder; they are not based on scientific evidence.

To date, the Systematic Treatment Enhancement Program for Bipolar Disorder has enrolled 1205 patients at 17 centers, which all use a common set of model practice procedures. This project has broad inclusion and minimal exclusion criteria and uses a hybrid design that includes randomized and standard treatment pathways; it will be a longitudinal study. The study criteria are intended to maximize the generalizability of the findings.

Dr. Sachs presented data from the STEP study on treatment of new-onset depressive episodes in bipolar patients. Subjects were treated for depression within 21 days of onset of the depressive episode. One group (of 44 patients) received mood stabilizers and a second group (49 patients) received combination treatment with mood stabilizers and antidepressants.

Recovery from depression was observed in 26% of patients treated with mood stabilizers and antidepressants, and in 25% of patients treated with mood stabilizers alone. Mood-switching to mania occurred in 18% of patients treated with mood stabilizers and antidepressants and in 11% of patients treated with mood stabilizers alone. The time to evidence of first recovery was significantly shorter in patients treated with mood stabilizers and antidepressants than in patients treated with mood stabilizers alone. Both treatment groups showed similar rates of recovery.