title: Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants.
abstract: 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.
authors.affiliation: 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
authors.forename: Lori L
authors.initials: LL
authors.lastname: Altshuler
authors.forename: Trisha
authors.initials: T
authors.lastname: Suppes
authors.forename: David O
authors.initials: DO
authors.lastname: Black
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: Gabriele
authors.initials: G
authors.lastname: Leverich
authors.forename: Paul E
authors.initials: PE
authors.lastname: Keck
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
authors.forename: Ralph
authors.initials: R
authors.lastname: Kupka
authors.forename: Susan L
authors.initials: SL
authors.lastname: McElroy
authors.forename: Heinz
authors.initials: H
authors.lastname: Grunze
authors.forename: Christina M R
authors.initials: CM
authors.lastname: Kitchen
authors.forename: Robert
authors.initials: R
authors.lastname: Post
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D008094:Lithium