Bipolar disorder: recent clinical trials and emerging therapies for depressive episodes and maintenance treatment

•We reviewed 44 recent clinical trials for treatment needs in bipolar disorder.•Lurasidone was recently approved for adult depressive episodes.•The olanzapine–fluoxetine combination was approved for pediatric depressive episodes.•Paliperidone extended release prevented relapse in clinically stable patients.•Mifepristone improved spatial working memory in bipolar depression.

Bipolar disorder (BD) is one of the world's ten most disabling conditions. More options are urgently needed for treating bipolar depressive episodes and for safer, more tolerable long-term maintenance treatment. We reviewed 30 recent clinical trials in depressive episodes (eight tested compounds) and 14 clinical trials in maintenance treatment (ten tested compounds). Positive results in Phase III trials, regulatory approval and/or new therapeutic indications were obtained with some of the developing drugs, particularly for depressive episodes. The current BD pipeline is encouraging with promising new compounds, acting on novel pharmacological targets and on specific aspects of bipolar depression.