American Board of Internal Medicine (ABIM) Certification Practice Exam

Which pharmacologic treatment is FDA-approved for bipolar depression?

1. Quetiapine monotherapy

2. Buspirone combination

3. Antidepressant therapy

4. Lithium and valproate

The correct answer is: Quetiapine monotherapy

Quetiapine monotherapy is recognized as an FDA-approved treatment specifically for bipolar depression. Quetiapine, which is an atypical antipsychotic, has demonstrated significant efficacy in alleviating depressive symptoms in individuals with bipolar disorder. Through multiple clinical trials, it has shown to be effective in both acute treatment and maintenance of bipolar depression, making it an appropriate choice for this condition. The FDA's approval highlights its role as a first-line treatment option in managing the depressive phase of bipolar disorder. This is particularly relevant because bipolar depression requires careful management; it is crucial to avoid treatments that could potentially destabilize the mood. In contrast, other options do not align with the established FDA approvals for bipolar depression specifically. For example, buspirone is not typically used as a primary treatment for bipolar depression. Antidepressants, while sometimes used, have not been approved as monotherapy due to concerns about inducing mania in susceptible individuals. Similarly, lithium and valproate, while useful for stabilizing mood in bipolar disorder as a whole, are not specifically labeled by the FDA for the treatment of bipolar depression on their own.