Am J Psychiatry 161:163-165, January 2004
© 2004 American Psychiatric Association
Antidepressant Treatment in Bipolar Versus Unipolar Depression
S. Nassir Ghaemi, M.D.,
Klara J. Rosenquist, B.S.,
James Y. Ko, A.B.,
Claudia F. Baldassano, M.D.,
Nicholas J. Kontos, M.D., and
Ross J. Baldessarini, M.D.
OBJECTIVE: Antidepressant responses were compared in DSM-IV bipolar and unipolar depression. METHOD: The authors analyzed clinical records for outcomes of antidepressant trials for 41 patients with bipolar depression and 37 with unipolar depression, similar in age and sex distribution. RESULTS: Short-term nonresponse was more frequent in bipolar (51.3%) than unipolar (31.6%) depression. Manic switching occurred only in bipolar depression but happened less in patients taking mood stabilizers (31.6% versus 84.2%). Cycle acceleration occurred only in bipolar depression (25.6%), with new rapid cycling in 32.1%. Late response loss (tolerance) was 3.4 times as frequent, and withdrawal relapse into depression was 4.7 times less frequent, in bipolar as in unipolar depression. Mood stabilizers did not prevent cycle acceleration, rapid cycling, or response loss. Modern antidepressants, in general, did not have lower rates of negative outcomes than tricyclic antidepressants. CONCLUSIONS: The findings suggest an unfavorable cost/benefit ratio for antidepressant treatment of bipolar depression.
This article has been cited by other articles:
|
|
|
|
 
R. Baldessarini, H. Henk, A. Sklar, J. Chang, and L. Leahy
Psychotropic Medications for Patients With Bipolar Disorder in the United States: Polytherapy and Adherence
Psychiatr Serv,
October 1, 2008;
59(10):
1175 - 1183.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. C. Viguera, T. Whitfield, R. J. Baldessarini, D. J. Newport, Z. Stowe, A. Reminick, A. Zurick, and L. S. Cohen
Risk of Recurrence in Women With Bipolar Disorder During Pregnancy: Prospective Study of Mood Stabilizer Discontinuation
Am J Psychiatry,
December 1, 2007;
164(12):
1817 - 1824.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Cukor, S. D. Cohen, R. A. Peterson, and P. L. Kimmel
Psychosocial Aspects of Chronic Disease: ESRD as a Paradigmatic Illness
J. Am. Soc. Nephrol.,
December 1, 2007;
18(12):
3042 - 3055.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. F. Baldassano
Management of Bipolar Disorder in the Acute and Maintenance Settings
Journal of the American Psychiatric Nurses Association,
November 1, 2007;
13(5_suppl):
S16 - S22.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. D. Cohen, L. Norris, K. Acquaviva, R. A. Peterson, and P. L. Kimmel
Screening, Diagnosis, and Treatment of Depression in Patients with End-Stage Renal Disease
Clin. J. Am. Soc. Nephrol.,
November 1, 2007;
2(6):
1332 - 1342.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Baldessarini, L. Leahy, S. Arcona, D. Gause, W. Zhang, and J. Hennen
Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders
Psychiatr Serv,
January 1, 2007;
58(1):
85 - 91.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. H. Levine and R. C. Albucher
Patient Management Exercise FOR BIPOLAR DISORDER
Focus,
January 1, 2007;
5(1):
20 - 32.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. S. Leverich, L. L. Altshuler, M. A. Frye, T. Suppes, S. L. McElroy, P. E. Keck Jr., R. W. Kupka, K. D. Denicoff, W. A. Nolen, H. Grunze, et al.
Risk of Switch in Mood Polarity to Hypomania or Mania in Patients With Bipolar Depression During Acute and Continuation Trials of Venlafaxine, Sertraline, and Bupropion as Adjuncts to Mood Stabilizers
Focus,
January 1, 2007;
5(1):
98 - 106.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. N Sokolski
Adjunctive Aripiprazole in Bipolar I Depression
Ann. Pharmacother.,
January 1, 2007;
41(1):
35 - 40.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. S. Leverich, L. L. Altshuler, M. A. Frye, T. Suppes, S. L. McElroy, P. E. Keck Jr., R. W. Kupka, K. D. Denicoff, W. A. Nolen, H. Grunze, et al.
Risk of Switch in Mood Polarity to Hypomania or Mania in Patients With Bipolar Depression During Acute and Continuation Trials of Venlafaxine, Sertraline, and Bupropion as Adjuncts to Mood Stabilizers
Am J Psychiatry,
February 1, 2006;
163(2):
232 - 239.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Olfson, A. K. Das, M. J. Gameroff, D. Pilowsky, A. Feder, R. Gross, R. Lantigua, S. Shea, and M. M. Weissman
Bipolar Depression in a Low-Income Primary Care Clinic
Am J Psychiatry,
November 1, 2005;
162(11):
2146 - 2151.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. C. FETTER and K. D. ASKLAND
Antidepressants for Bipolar Depression
Am J Psychiatry,
August 1, 2005;
162(8):
1546 - 1546.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. A. Hirschfeld, A. R. Cass, D. C. L. Holt, and C. A. Carlson
Screening for Bipolar Disorder in Patients Treated for Depression in a Family Medicine Clinic
J Am Board Fam Med,
July 1, 2005;
18(4):
233 - 239.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Frangou
Advancing the pharmacological treatment of bipolar depression
Advan. Psychiatr. Treat.,
January 1, 2005;
11(1):
28 - 37.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Rosack
Med Check
Psychiatr News,
January 16, 2004;
39(2):
25 - 25.
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 2004
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
