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FOCUS Quiz: Summer 2019 - Evidence-Based Principles for Bipolar Disorder Treatment

Activity Type:

  • Journal CME

Release Date: 7/1/2019

Expiration Date: 12/31/2021

  • AMA PRA Category 1: 5
  • Participation: 5



Evidence-Based Principles for Bipolar Disorder Treatment

FOCUS, APA's clinical review and continuing medical education journal, is designed as a personal study resource to help practicing psychiatrists keep abreast of significant advances in the field, with particular attention to clinical practice and incorporation of core competencies. The goal of FOCUS is the dissemination of up-to-date clinical information, facilitation of lifelong learning skills, maintenance of certification, and opportunity for self-assessment in order to improve patient care. Each issue, prepared by distinguished faculty who are recognized in their fields, provides up to date clinical information and incorporates a CME component. The material can be used effectively by establishing a regular schedule of study.


This activity is only available to 2019 Focus subscribers.

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Educational Objectives

This issue of Focus provides the reader with a current view of evidence-based principles for bipolar disorder treatment.

Participants will:

  • Be able to incorporate an approach to evidence-based practices in treating bipolar disorder, in which patients’ atypical, comorbidly ill, multi-combination therapy, treatment-resistant and psychosocially complicated context are considered
  • Review state-of-the-art treatments that reflect best practice and credible empirical observations from randomized trials
  • Be able to apply randomized controlled trial data to individual patients
  • Review evidence for complex combination therapies and emerging pharmacotherapies
  • Gauge risks and benefits of pharmacotherapy during pregnancy and lactation

Target Audience

This program is one element of a lifelong learning program for psychiatrists and is an aid for psychiatrists and other clinicians participating in maintenance of certification.

Estimated Time to Complete

Estimated Duration: 5 hours
Begin Date: July 1, 2019
End Date: December 31, 2021

How to Earn Credit

In order to earn CME credit, participants should read through the material presented in the issue. After reading the materials, complete the CME quiz by answering multiple-choice questions with a single correct answer. A score of 60% or higher is required to receive credit. Retakes are available for the test. Review the rationales, complete the online course evaluation, and then claim and print your CME certificate. The APA provides a CME certificate of credit for physicians and a certificate of participation for non-physicians.


The American Psychiatric Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The APA designates this journal-based CME activity for a maximum of 5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Planner Disclosures

Program Planners – Editor and Associate Editors and Guest Editors

Mark H. Rapaport,  MD, Editor of FOCUS, and Chairman and Chief of Psychiatric Services, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Ga. No financial relationships with commercial interests.

Dorothy Stubbe, MD, Editor and Author, Communications Commentary, Associate Professor and Program Director, Yale University School of Medicine Child Study Center, New Haven, CT.- No financial relationships with commercial interests.

Laura Dunn,  MD, Co-Editor Ethics Column; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA; Dr. Dunn reports: Consultant: Otsuka America Pharmaceutical Inc.

Personalized Pharmacotherapy for Bipolar Disorder: How to Tailor Findings From Randomized Trials to Individual Patient-Level Outcomes


Complex Combination Pharmacotherapy for Bipolar Disorder: Knowing When Less Is More or More Is Better

Joseph F. Goldberg, M.D. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City.

Dr. Goldberg is a consultant for Lundbeck, Neurocrine, Otsuka, Sunovion, and WebMD. He is on the speakers bureaus for Allergan, Neurocrine, Otsuka, Sunovion, and Takeda-Lundbeck. Dr. Goldberg receives royalties from American Psychiatric Association Publishing.

Psychopharmacology and Experimental Therapeutics for Bipolar Depression

Manish K. Jha, M.B.B.S., and James W. Murrough, M.D., Ph.D. Depression and Anxiety Center for Discovery and Treatment and Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York City. Dr. Jha has received contract research grants from Janssen Research and Acadia Pharmaceuticals. Dr. Murrough has provided consultation services to Clexio Biosciences, Boehreinger Ingelheim, Sage Therapeutics,FSV7, Novartis, Allergan, Fortress Biotech, Janssen Research and Development, Medavante-Prophase, and Global Medical Education and has received research support from Avanir Pharmaceuticals, Inc. Dr. Murrough is named on a patent pending for neuropeptide Y as a treatment for mood and anxiety disorders. The Icahn School of Medicine (employer of Drs. Jha and Murrough) is named on a patent and has entered into a licensing agreement and will receive payments related to the use of ketamine if it is approved for the treatment of depression. Drs. Jha and Murrough are not named on this patent and will not receive any payments.

Evidence-Based Psychotherapies for Bipolar Disorder

Danielle M. Novick, Ph.D., and Holly A. Swartz, M.D. Outpatient Mood Disorders Clinic and Clinical Training Committee, VA Pittsburgh Healthcare System, Pittsburgh (Novick); Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Swartz). Dr. Novick reports no financial relationships with commercial interests. Dr. Swartz has received consulting fees from Otsuka and Myriad Genetics, grant support from Myriad Genetics, royalties from UpToDate, and an editorial stipend from American Psychiatric Association Publishing for her role as editor of the American Journal of Psychotherapy.

Psychopharmacological Decision Making in Bipolar Disorder During Pregnancy and Lactation: A Case-by-Case Approach to Using Current Evidence

Elizabeth Albertini, M.D., Carrie L. Ernst, M.D., Rachel S. Tamaroff, M.D. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York. Dr. Ernst reports that her spouse has served as a consultant for Neurocrine, Lundbeck, Otsuka, Sunovion, and WebMD; that he is on the speakers’ bureau for Allergan, Neurocrine, Otsuka, Sunovion, Takeda- Lundbeck; and that he receives royalties from American Psychiatric Publishing, Inc. Dr. Ernst reports no financial relationships with commercial interests for herself. The other authors report no financial relationships with commercial interests.

Working With a Patient With Bipolar I Disorder Who Is Experiencing Depression

Jeffrey J. Rakofsky, M.D. Emory University School of Medicine, Atlanta. Dr. Rakofsky reports grant support from Takeda Pharmaceutical Company, the National Institute of Mental Health, and the American Board of Psychiatry and Neurology.

Ethical Issues in the Diagnosis and Treatment of Bipolar Disorders

Michael J. Ostacher, M.D., M.P.H. Department of Psychiatry, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, and Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto. Send correspondence to Dr. Ostacher ( In the past 36 months, Dr. Ostacher has been a consultant to Alkermes, Johnson & Johnson (Janssen), Lundbeck, Otsuka, Sage Therapeutics, and Supernus Pharmaceuticals; he has received research funding from Palo Alto Health Sciences, Inc.

Xanadu and Mood Stabilization

Ian A. Cook, M.D. Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, and Los Angeles TMS Institute. Dr. Cook reports that the University of California, Los Angeles (UCLA), received research grant funding from NeoSync, Inc., for his work there prior to retirement and that his active biomedical device patents are assigned to the University of California. He has been granted stock options in NeuroSigma, the licensee of some of his inventions, and he currently is on leave as its chief medical officer and senior vice president. Dr. Cook has equity positions and leadership roles in HeartCloud, Inc., and the BrainCloud Corporation.

American Psychiatric Association Staff Involved in Planning:  

Tristan Gorrindo,  MD  Director, Division of Education, APA – no conflicts

Kristen Moeller, Director of CME, Associate Director of FOCUS – no conflicts 

Hardware/Software Requirements

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration

  • Flash Player: Adobe Flash Player 10.1+ 
  • Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+ 
  • Operating System: Windows XP+ or Mac OS X 10.4+ 
  • Internet Connection: 1 Mbps or higher

Minimum Requirements

Windows PC:
500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera

Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit

For assistance: Contact for questions about this course | Contact for technical assistance