title: Mood changes related to antidepressants: a longitudinal study of patients with bipolar disorder in a naturalistic setting.
abstract: This prospective, longitudinal study investigated the frequency and pattern of mood changes between outpatients receiving usual care for bipolar disorder who were either taking or not taking antidepressants. Eighty patients with bipolar disorder self-reported mood and psychiatric medications daily for 3 months using a computerized system (ChronoRecord) and returned 8662 days of data. Of the total group of 80 patients, 47 took antidepressants; 33 did not. Patients taking antidepressants reported depression twice as frequently (29% of days vs. 13.8% of days). In both groups, two-thirds of all mood changes over a 1-, 2- and 3-day period were small, between -5 and 5 on a 100-point scale. No statistically significant difference was found in the frequency of large mood changes (>10 on a 100-point scale) or in switches between depression and mania (0.7% if not taking antidepressants vs. 0.9% if taking), independent of diagnosis of bipolar I or II. Eighty-nine percent of patients taking antidepressants were also taking mood stabilizers. In this naturalistic setting, no significant difference between the rate of switches to mania or rapid cycling was found between those taking and not taking antidepressants, regardless of diagnosis. The primary difference in pattern between the groups was the time spent in depressed or normal mood, with minor daily mood variations.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité-Mitte, Schumannstr. 20/21, 10117 Berlin, Germany. michael.bauer@charite.de
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Natalie
authors.initials: N
authors.lastname: Rasgon
authors.forename: Paul
authors.initials: P
authors.lastname: Grof
authors.forename: Lori
authors.initials: L
authors.lastname: Altshuler
authors.forename: Laszlo
authors.initials: L
authors.lastname: Gyulai
authors.forename: Manfred
authors.initials: M
authors.lastname: Lapp
authors.forename: Tasha
authors.initials: T
authors.lastname: Glenn
authors.forename: Peter C
authors.initials: PC
authors.lastname: Whybrow
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects*; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D002940:Circadian Rhythm / Q000187:drug effects; D003625:Data Collection / Q000295:instrumentation / Q000379:methods; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012984:Software
chemical_list: D000928:Antidepressive Agents