Bipoler Depression in it's acute psase is a very distressing state for the suffering patient & a chalanging job for the Psychaitrist to treat to alliavete in a reasonable period of time.

In acute state Bipolar patients, mostly women in their middle age, moderately overweigted often presents with a crying state or even with potent suicidal ideation that continiue to go on inspite of treatment with pharmacological treatments.

Here is an attempt to search for a remedy to these set of patients.

72 acutely ill Bipolar depressed patient were assigned with 3 treatment regimens, after their diagnosis was confirmed on the criteria of DSM-4 TR.

There age group were 46 to58 years with a median age 52 years. There were 12 Ist episode depressive phase and 60 patients both male 24 & women 36 are recurent sufferers.The Study was conducted in the O.P.D patiends attending Calcutta Pavlov Hospital during 2008-09.

1st. group receive only Fluoxotine & olanzapin combination for 6 weeks.

2nd group recieve FLuox+Olanzapin +lithium carbonate in 900 mg/day dose.

3rd group recieve Lith. carobonate+Olz.+fluoxotine +Lamotrigine in 25-50mg/d.

The 1st group with a combo of olanzapin+Fluoxotine were the least responsive.

They were evaluated in the Psychologist table usinng ASPER-Montigegmy Depression rating scale.

Allthe groups shows improvement in different items of the scale.

3rd group using a tripple drug Combo therapy do the best.

Is a poly combo drug therapy or E.C.T or +Psychotherapy combo a best answeer to these criticaly depressed BPD patients.