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Include site-specific details, treatment history, and outcomes to demonstrate medical necessity

The paper summarises: 1) findings from a recent systematic review and network meta-analysis on comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults published by Yildiz et al in Lancet Psychiatry 2023 [7], 2) the risk of switching to mania associated with the use of antidepressants for bipolar depression and 3) the pharmacological recommendations for treatment of bipolar depression by the Canadian Network for Mood and Anxiety Treatments (CANMAT) and the International Society for Bipolar Disorders (ISBD), 2018, [12] 4) the use of electroconvulsive therapy (ECT) for bipolar depression and 5) arguments for giving priority to drugs that have a proven effects in all phases of bipolar disorder