title: Double-blind comparison of addition of a second mood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression.
abstract: OBJECTIVE
  This study's purpose was to clarify the appropriate treatment of bipolar depression by comparing the addition of an antidepressant versus a second mood stabilizer for inpatients being treated with lithium carbonate or divalproex sodium.
  
  
  METHODS
  Twenty-seven patients were randomly assigned to groups that received double-blind treatment with paroxetine or a second mood stabilizer (lithium carbonate or divalproex sodium) for 6 weeks.
  
  
  RESULTS
  Both groups showed significant improvement in depressive symptoms during the 6-week trial. There were significantly more noncompleters in the group being treated with the two mood stabilizers than in the group being treated with a mood stabilizer and paroxetine.
  
  
  CONCLUSIONS
  Both treatments appeared to be effective; however, the addition of an antidepressant may have greater clinical utility in the treatment of bipolar depression.
authors.affiliation: Mood Disorders Program, Hamilton Psychiatric Hospital, Hamilton, Ont., Canada. youngt@fhs.mcmaster.ca
authors.forename: L T
authors.initials: LT
authors.lastname: Young
authors.forename: R T
authors.initials: RT
authors.lastname: Joffe
authors.forename: J C
authors.initials: JC
authors.lastname: Robb
authors.forename: G M
authors.initials: GM
authors.lastname: MacQueen
authors.forename: M
authors.initials: M
authors.lastname: Marriott
authors.forename: I
authors.initials: I
authors.lastname: Patelis-Siotis
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D018021:Lithium Chloride / Q000627:therapeutic use*; D008297:Male; D017374:Paroxetine / Q000627:therapeutic use*; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D018692:Antimanic Agents; D017374:Paroxetine; D014635:Valproic Acid; D018021:Lithium Chloride