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Titolo:
Rate of switch in bipolar patients prospectively treated with second-generation antidepressants as augmentation to mood stabilizers
Autore:
Post, RM; Altshuler, LL; Frye, MA; Suppes, T; Rush, AJ; Keck, PE; McElroy, SL; Denicoff, KD; Leverich, GS; Kupka, R; Nolen, WA;
Indirizzi:
NIMH, Biol Psychiat Branch, NIH, Bethesda, MD 20892 USA NIMH Bethesda MD USA 20892 l Psychiat Branch, NIH, Bethesda, MD 20892 USA Los Angeles VA Hosp, Los Angeles, CA USA Los Angeles VA Hosp Los Angeles CA USA eles VA Hosp, Los Angeles, CA USA Univ Calif Los Angeles, Ambulatory Clin Res Ctr, Los Angeles, CA USA Univ Calif Los Angeles Los Angeles CA USA n Res Ctr, Los Angeles, CA USA Univ Texas, SW Med Ctr, Dallas, TX USA Univ Texas Dallas TX USAUniv Texas, SW Med Ctr, Dallas, TX USA Univ Cincinnati, Coll Med, Cincinnati, OH USA Univ Cincinnati Cincinnati OH USA ncinnati, Coll Med, Cincinnati, OH USA Univ Utrecht, Med Ctr, Utrecht, Netherlands Univ Utrecht Utrecht Netherlands Utrecht, Med Ctr, Utrecht, Netherlands Altrecht Inst Mental Hlth Care, Utrecht, Netherlands Altrecht Inst Mental Hlth Care Utrecht Netherlands Utrecht, Netherlands
Titolo Testata:
BIPOLAR DISORDERS
fascicolo: 5, volume: 3, anno: 2001,
pagine: 259 - 265
SICI:
1398-5647(200110)3:5<259:ROSIBP>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEPRESSIVE SYMPTOMATOLOGY IDS; AFFECTIVE-ILLNESS; LITHIUM-CARBONATE; PROPHYLACTIC EFFICACY; AFFECTIVE-DISORDERS; NUCLEUS-ACCUMBENS; ANTI-DEPRESSANTS; CAUSE MANIA; BUPROPION; IMIPRAMINE;
Keywords:
antidepressants; biopolar; bupropion; controlled trial; depression; hypomania; mania; sertraline; switching; venlafaxine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Post, RM NIMH, Biol Psychiat Branch, NIH, 10 Ctr Dr,MSC 1272,Bldg 10,Room 3S239, Bethesda, MD 20892 USA NIMH 10 Ctr Dr,MSC 1272,Bldg 10,Room 3S239 Bethesda MD USA 20892
Citazione:
R.M. Post et al., "Rate of switch in bipolar patients prospectively treated with second-generation antidepressants as augmentation to mood stabilizers", BIPOL DIS, 3(5), 2001, pp. 259-265

Abstract

Introduction: Bipolar patients with breakthrough major depressive episodesdespite ongoing adequately-dosed mood stabilizer medication were randomized in a double-blind manner to one of three antidepressants with different mechanisms of action: bupropion, sertraline, or venlafaxine. Preliminary data are presented on the switch rates into hypomania or mania for the antidepressants as a group prior to unblinding the specific individual drug efficacy and tolerability data in this ongoing clinical trial. Methods: Subjects included 64 bipolar patients who participated at five sites in a 10-week double-blind trial for depression and a 1-year blinded continuation maintenance phase for responders. Nonresponders were re-randomized such that there were 95 acute treatment phases. In the acute phase, doseswere titrated to clinical response, side effects, or maximum dose of bupropion (450 mg/day), sertraline (200 mg/day), or venlafaxine (375 mg/day). Daily ratings on the National Institute of Mental Health-Life Chart Methodology (NIMH-LCM) were inspected for the degree of improvement on the Clinical Global Impressions scale as revised for bipolar illness (CGI-BP) and the occurrence of hypomania or mania. Results: Thirty-five (37%) of the 95 acute treatment phases were associated with a much or very much improved rating in depression on the CGI-BP. Thirteen (14%) of these 95 acute trials of antidepressants as adjuncts to moodstabilizers were associated with switches, seven into hypomania and six into mania. Forty-two patients elected to go into the continuation phase in 48 instances. Sixteen (33%) of the continuation phase trials were associatedwith mood switches, 10 into hypomania and six into mania. Results: Thirty-five (37%) of the 95 acute treatment phases were associated with a much or very much improved rating in depression on the CGI-BP. Thirteen (14%) of these 95 acute trials of antidepressants as adjuncts to moodstabilizers were associated with switches, seven into hypomania and six into mania. Forty-two patients elected to go into the continuation phase in 48 instances. Sixteen (33%) of the continuation phase trials were associatedwith mood switches, 10 into hypomania and six into mania. Conclusions: In this randomized double-blind prospective study of three second-generation antidepressants (bupropion, sertraline, and venlafaxine) inbipolar patients whose depression broke through ongoing treatment with mood stabilizers, switches into hypomania or mania occurred in 14% of the acute phases and 33% of the continuation phases. Individual data on each drug will be assessed in the next phase of the study after more subjects are recruited and the blind is broken.

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Documento generato il 19/01/20 alle ore 09:59:16