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Titolo:
Long-term naturalistic treatment of depressive symptoms in bipolar illnesswith divalproex vs. lithium in the setting of minimal antidepressant use
Autore:
Ghaemi, SN; Goodwin, FK;
Indirizzi:
Harvard Univ, Sch Med, Consolidated Dept Psychiat, Psychopharmacol Program,Cambridge Hosp, Cambridge, England Harvard Univ Cambridge England ogram,Cambridge Hosp, Cambridge, England George Washington Univ, Dept Psychiat, Ctr Neurosci Med Progress & Soc, Washington, DC USA George Washington Univ Washington DC USA gress & Soc, Washington, DC USA
Titolo Testata:
JOURNAL OF AFFECTIVE DISORDERS
fascicolo: 3, volume: 65, anno: 2001,
pagine: 281 - 287
SICI:
0165-0327(200108)65:3<281:LNTODS>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISORDER; MANIA; CARBONATE; EFFICACY;
Keywords:
bipolar disorder; drug therapy; valproate; divalproex sodium; valproic acid; lithium carbonate; outcome; side effects; treatment resistance; depression;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Ghaemi, SN Harvard Univ, Sch Med, Consolidated Dept Psychiat, Psychopharmacol Program,Cambridge Hosp, Cambridge, England Harvard Univ Cambridge England idge Hosp, Cambridge, England
Citazione:
S.N. Ghaemi e F.K. Goodwin, "Long-term naturalistic treatment of depressive symptoms in bipolar illnesswith divalproex vs. lithium in the setting of minimal antidepressant use", J AFFECT D, 65(3), 2001, pp. 281-287

Abstract

Objective: Risks have been associated with the long-term use of antidepressant in the treatment of bipolar disorder. We review our naturalistic experience with divalproex versus lithium in treating depressive symptoms of bipolar illness. Method: All patients with bipolar disorder treated with lithium or divalproex were identified in a university outpatient psychiatry clinic sample over one year (n = 38 patients, 41 treatment trials). Treatment response was based on standard prospective symptom rating scales. Mean duration of follow-up was 90 weeks, Results: Lithium and divalproex were equallyeffective and tolerated in the total sample, Antidepressant effects were noted despite sparing use of standard antidepressant agents (19% received them). Lithium non-responders responded well to divalproex (50%), and vice versa (44%). Divalproex monotherapy (24%) was more common than lithium monotherapy (7%, P = 0.07) and was notably effective in treating depressive symptoms, with a 7/10 response on the CGI-BP and improvement on the HDRS (14.8 +/-9.2 to 7.6 +/-7.8, P = 0.003, duration of prospective follow up 26.7 weeks). Conclusions: Lithium and divalproex were equally effective and tolerated in this naturalistic sample, but responders may represent distinct subgroups. Both agents, but particularly divalproex, demonstrated long-term antidepressant effects, with limited adjunctive standard antidepressant use. (C)2001 Elsevier Science BY All rights reserved.

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Documento generato il 29/03/20 alle ore 01:52:30