The authors bring attention to the diagnosis of bipolar depression, which is most often misdiagnosed as unipolar depression with all the consequences. With acute treatment in patients already treated with mood stabilizers we should optimize levels and doses; in previously untreated patients we prefer lithium and lamotrigine. In the case of unsuccessful monotherapy an antidepressant is usually added. In spite of consensus of many algorithms the bipolar depression is not often treated with stabilizers. The situation at the Psychiatric Department in Brno was mapped. In the retrospective analysis totally 33 patients hospitalized during 2 years (November 2001–2003) with bipolar depression were identifi ed. At admission 24% were diagnosed as affected by unipolar depression, 12% came to the hospitalization after suicidal attempt and 12% were not treated before admission, whereas 51% came with mood stabilizers. More patients were dismissed with mood stabilizers (51% vs 81%, p=0.01).

        Key words: bipolar depression, unipolar depression, mood stabilizers, antidepressants