Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 139, Issue 1, Pages 89-93Publisher
ELSEVIER
DOI: 10.1016/j.jad.2012.01.027
Keywords
Antidepressants; Bipolar disorder; Depression; Mood-stabilizers; Response; Switch
Categories
Funding
- University of Barcelona
- Spanish Foundation of Psychiatry Mental Health
- Hospital Clinic of Barcelona
- Instituto de Salud Carlos III through the Centro para la Investigacion Biomedica en Red de Salud Mental (CIBERSAM)
- Generalitat de Catalunya [2009-SGR-1022]
- Bruce J. Anderson foundation
- McLean Private Donors Bipolar Disorder Research Fund
- Almirall
- Astra-Zeneca
- Bristol-Myers-Squibb
- Eli Lilly
- Forest Research Institute
- Gedeon Richter
- Glaxo-Smith-Kline
- Janssen-Cilag
- Jazz
- Lundbeck
- Merck
- Novartis
- Otsuka
- Pfizer
- Sanofi
- Servier
- Schering-Plough
- Takeda
- United Biosource Corporations
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Background: The efficacy and tolerability of antidepressants (ADs) to treat or avoid episodes of depression in bipolar disorder (BPD) patients as well as reasons for using them remain unresolved. Methods: We analyzed patient-characteristics and outcomes of episodes of acute major depression among 290 adult, DSM-IV BPD patients (71% type-I, 52% women) at the Hospital Clinic of Barcelona; 80% were given an AD and 20% were not; 80% of both groups also received mood-stabilizers. We evaluated factors associated with AD-treatment using bivariate analyses and multiple logistic-regression modeling. Results: Factors associated with AD-use by multivariate modeling ranked: [a] more years ill, [b] depressive first-lifetime episode, [c] more depressions/year, [d] melancholic index episode, and le] less affective illness in first-degree relatives. Within 8 weeks, depression improved by >= 50%, less often among BPD patients given an AD (64.4%; 38.6% without switching into hypo/mania) than not (82.1%; 78.6% without switching). Conclusions: Use of ADs to treat acute BP-depression was very common and associated with a more severe clinical history. Mood-switching was prevalent with AD-treatment even with mood-stabilizers present. (C) 2012 Elsevier B.V. All rights reserved.
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