Effectiveness and safety of long-term antidepressant treatment in bipolar disorder.
OBJECTIVE
We sought to review research on use of antidepressants for long-term treatment of bipolar depression.


METHODS
We conducted a computerized literature search of the MEDLINE, HealthStar, Current Contents, PsychInfo, and National Library of Medicine databases to identify studies involving antidepressant, anticonvulsant, or lithium use in bipolar disorder or manic-depressive illness published from 1966 through 2000.


RESULTS
Only 7 blinded, controlled trials of long-term antidepressant treatment in bipolar disorders were found. The available information is not adequate to support the safety or effectiveness of long-term antidepressant treatment for bipolar depression, with or without mood-stabilizing cotherapy.


CONCLUSIONS
Antidepressant treatment of bipolar depression is extraordinarily understudied. Controlled trials comparing specific antidepressants, particularly to compare mood-stabilizing agents given alone and combined with an antidepressant, are needed.
Ghaemi
S N
SN
Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass, USA. nassir_ghaemi@hms.harvard.edu
Lenox
M S
MS
Baldessarini
R J
RJ
D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D018849:Controlled Clinical Trials as Topic / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D016896:Treatment Outcome
D000927:Anticonvulsants; D000928:Antidepressive Agents; D008094:Lithium