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.
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.
Young
L T
LT
Mood Disorders Program, Hamilton Psychiatric Hospital, Hamilton, Ont., Canada. youngt@fhs.mcmaster.ca
Joffe
R T
RT
Robb
J C
JC
MacQueen
G M
GM
Marriott
M
M
Patelis-Siotis
I
I
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*
D018687:Antidepressive Agents, Second-Generation; D018692:Antimanic Agents; D017374:Paroxetine; D014635:Valproic Acid; D018021:Lithium Chloride