4.7 Article

Bipolar depression: Clinical correlates of receiving antidepressants

Journal

JOURNAL OF AFFECTIVE DISORDERS
Volume 139, Issue 1, Pages 89-93

Publisher

ELSEVIER
DOI: 10.1016/j.jad.2012.01.027

Keywords

Antidepressants; Bipolar disorder; Depression; Mood-stabilizers; Response; Switch

Funding

  1. University of Barcelona
  2. Spanish Foundation of Psychiatry Mental Health
  3. Hospital Clinic of Barcelona
  4. Instituto de Salud Carlos III through the Centro para la Investigacion Biomedica en Red de Salud Mental (CIBERSAM)
  5. Generalitat de Catalunya [2009-SGR-1022]
  6. Bruce J. Anderson foundation
  7. McLean Private Donors Bipolar Disorder Research Fund
  8. Almirall
  9. Astra-Zeneca
  10. Bristol-Myers-Squibb
  11. Eli Lilly
  12. Forest Research Institute
  13. Gedeon Richter
  14. Glaxo-Smith-Kline
  15. Janssen-Cilag
  16. Jazz
  17. Lundbeck
  18. Merck
  19. Novartis
  20. Otsuka
  21. Pfizer
  22. Sanofi
  23. Servier
  24. Schering-Plough
  25. Takeda
  26. 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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