Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants.
OBJECTIVE
The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder.


METHODS
In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with bipolar II disorder, two with bipolar disorder not otherwise specified) were treated with one of three antidepressants as an adjunct to mood stabilizers. The patients' switch rates were assessed. Switch was defined as a Young Mania Rating Scale (YMRS) score >13 or a Clinical Global Impression (CGI) mania score > or =3 (mildly ill).


RESULTS
Depressed subjects with bipolar II disorder had a significantly lower acute switch rate into hypomania/mania when either YMRS or CGI criteria were used to define switch.


CONCLUSIONS
These data suggest that depressed patients with bipolar II disorder are less vulnerable than those with bipolar I disorder to switch into hypomania/mania when treated with an antidepressant adjunctive to a mood stabilizer.
Altshuler
Lori L
LL
Dept. of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 300 UCLA Medical Plaza, Suite 1544, Box 957057, Los Angeles, CA 90095-7057. laltshuler@mednet.ucla.edu
Suppes
Trisha
T
Black
David O
DO
Nolen
Willem A
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Leverich
Gabriele
G
Keck
Paul E
PE
Frye
Mark A
MA
Kupka
Ralph
R
McElroy
Susan L
SL
Grunze
Heinz
H
Kitchen
Christina M R
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Post
Robert
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D000328:Adult; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D011569:Psychiatric Status Rating Scales; D012008:Recurrence
D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D008094:Lithium