Mood-Stabilizing Effect of Twice-Weekly Administration of Fluoxetine in a Bipolar II Disorder Patient

Sir: Bipolar II disorder is a valid and reliable diagnosis and its prevalence in society is higher than was once assumed. Considering the fact that the main clinical presentation of bipolar II disorder is composed of depressive symptoms and the fact that the retrospective diagnosis of episodes of hypomania is often difficult, there has been an increased concern about the underdiagnosis of bipolar II disorder in clinical practice in recent years, and suggestions have been put forward in order to reach correct diagnosis. Nevertheless, treatment guidelines for bipolar disorders are mainly based on findings of research on bipolar I disorder patients, and most bipolar II disorder treatment algorithms are not grounded in strong experimental findings. Moreover, according to existing evidence, not only are the clinical pictures and courses of bipolar I disorder and bipolar II disorder different, there are also clear differences with regard to treatment response, such as a lower incidence of switch to hypomania with antidepressants and even a case report of the mood stabilizing effect of selective serotonin reuptake inhibitors in bipolar II disorder. Therefore, a case is presented here with the aim of introducing a new method of fluoxetine administration in the treatment of bipolar II disorder.