The use of modern dopamine partial agonists in bipolar depression: is the evidence sound?

Bipolar depression is a leading cause of morbidity in patients with bipolar disorder (BD) with at least half of bipolar patients who initially present with a depressive episode. While several pharmacologic agents have been approved in Europe and are currently available for treating bipolar mania as monotherapy or adjunctive with currently available medications, there are limited evidence-based treatment options that may be successfully prescribed to treat bipolar depression. Novel encouraging data are now emerging concerning the use of partial dopamine agonists having different binding affinities for D2 and D3 dopamine receptors in the treatment of bipolar depression. Evidence demonstrated the initial use of these agents to treat depressed bipolar patients but findings are still quite controversial. The present Editorial provides a critical perspective about the current use of most recent partial dopamine agonists having different binding affinities for D2 and D3 dopamine receptors in the treatment of bipolar depression. Overall, novel encouraging data are now emerging regarding the use of partial dopamine agonists but future clinical studies in human subjects are warranted to extend our knowledge about the real-world effectiveness of these novel compunds in patients with bipolar depression.