Antidepressant Therapy in Treating Bipolar Type II Major Depression

Inclusion Criteria: * Meets DSM-IV criteria for Axis I bipolar II disorder * Meets DSM-IV criteria for Axis I major depressive episode * Score of 16 on 17-item HAM-D rating scale * Not taking monoamine oxidase inhibitors (MAOI) for more than 2 weeks prior to study entry * Willing to use an effective form of birth control throughout the study Exclusion Criteria: * History of mania * Current primary Axis I diagnosis other than bipolar II disorder * Alcohol or drug dependence within 3 months prior to study entry * Contraindication to treatment with venlafaxine or lithium * Unstable medical condition (e.g., thyroid disease, hypertension, or angina pectoris) * Pregnant or breastfeeding * Experiencing suicidal thoughts * Requires hospitalization * Requires concurrent neuroleptic or MS therapy * Requires concurrent AD therapy * Current psychotic features * Inadequate trial of therapy at the time of initial screening visit * History of intolerance to either venlafaxine or lithium * Unlikely to participate in a 36-week trial * Presence of apparent secondary gain