Efficacy and safety of antidepressant monotherapy in the treatment of bipolar-II depression.
Sparse data exist regarding the risks and benefits of treating bipolar-II depression with antidepressants alone. On the basis of studies of bipolar-I patients, treatment guidelines suggest antidepressants should be augmented with mood stabilizers. Whether these recommendations apply to bipolar-II is unclear. A post-hoc analysis of a double-blind study, which compared the relative efficacy of placebo, imipramine and phenelzine in depressed outpatients. Patients rated 1 ('very much improved') or 2 ('much improved') on the Clinical Global Inventory Scale were considered responders. In an intent to treat analysis, no significant differences between bipolar patients (N=62) and unipolar patients (N=248) in response rates to placebo, imipramine and phenelzine were seen. No patient developed manic symptoms that required medication discontinuation or mood stabilizer augmentation. Antidepressant monotherapy was found to be a safe and effective treatment for bipolar-II depression.
Agosti
Vito
V
New York State Psychiatric Institute and Columbia College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA. agostiv@pi.cpmc.columbia.edu
Stewart
Jonathan W
JW
D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003627:Data Interpretation, Statistical; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D007099:Imipramine / Q000009:adverse effects / Q000627:therapeutic use*; D010555:Personality Inventory; D010624:Phenelzine / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014481:United States
D000928:Antidepressive Agents; D010624:Phenelzine; D007099:Imipramine