BOSTON, March 29 -- If a depressed patient with bipolar disorder is taking a mood stabilizer such as lithium, adding an antidepressant has no more effect than a placebo, according to researchers here.
In a study of 366 depressed bipolar patients, durable recoveries were nearly identical, whether patients were randomized to an antidepressant or placebo, found Gary Sachs, M.D., of Massachusetts General Hospital here, and colleagues.
Also, there were no significant differences in a range of secondary endpoints of the 26-week trial, part of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) collaboration, the investigators reported online in the New England Journal of Medicine, scheduled for the April 26 print issue.
American physicians have been generally cautious about using antidepressants in bipolar patients, fearing that the drugs would spark manic episodes, Dr. Sachs and colleagues noted.
There had been only limited evidence that medications effective in treating unipolar depression are beneficial in depressed bipolar patients, they said.
Showing posts with label Bipolar Depression. Show all posts
Showing posts with label Bipolar Depression. Show all posts
Thursday, March 29, 2007
Adjunctive Antidepressants Associated with Neither Mania Nor Benefit in Bipolar Depression
Adjunctive paroxetine or bupropion in the treatment of depression associated with bipolar disorder offers no benefit over mood stabilizers alone but does not induce mania, according to a study published online by the New England Journal of Medicine.
Researchers randomized some 370 bipolar patients experiencing depressive episodes to up to 26 weeks of treatment with a mood stabilizer plus one of the two antidepressants or placebo. Rates of durable recovery (defined as at least 8 weeks of euthymia) were the same in the antidepressant (24%) and placebo (27%) groups, as were rates of cycling to mania (10% and 11%, respectively).
Journal Watch Psychiatry Editor-in-Chief Dr. Peter Roy-Byrne writes that the mania finding is reassuring, since "clinicians concerned about suicidality will continue to prescribe antidepressants for seriously depressed bipolar patients." An editorialist cautions that antidepressants may cause mania in the absence of mood stabilizers and that clinicians should check for a history of mania before initiating antidepressant treatment.
Researchers randomized some 370 bipolar patients experiencing depressive episodes to up to 26 weeks of treatment with a mood stabilizer plus one of the two antidepressants or placebo. Rates of durable recovery (defined as at least 8 weeks of euthymia) were the same in the antidepressant (24%) and placebo (27%) groups, as were rates of cycling to mania (10% and 11%, respectively).
Journal Watch Psychiatry Editor-in-Chief Dr. Peter Roy-Byrne writes that the mania finding is reassuring, since "clinicians concerned about suicidality will continue to prescribe antidepressants for seriously depressed bipolar patients." An editorialist cautions that antidepressants may cause mania in the absence of mood stabilizers and that clinicians should check for a history of mania before initiating antidepressant treatment.
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