title: Bipolar depression: clinical correlates of receiving antidepressants.
abstract: BACKGROUND
  The efficacy and tolerability of antidepressants (ADs) to treat or avoid episodes of depression in bipolar disorder (BPD) patients as well as reasons for using them remain unresolved.
  
  
  METHODS
  We analyzed patient-characteristics and outcomes of episodes of acute major depression among 290 adult, DSM-IV BPD patients (71% type-I, 52% women) at the Hospital Clinic of Barcelona; 80% were given an AD and 20% were not; 80% of both groups also received mood-stabilizers. We evaluated factors associated with AD-treatment using bivariate analyses and multiple logistic-regression modeling.
  
  
  RESULTS
  Factors associated with AD-use by multivariate modeling ranked: [a] more years ill, [b] depressive first-lifetime episode, [c] more depressions/year, [d] melancholic index episode, and [e] less affective illness in first-degree relatives. Within 8weeks, depression improved by ≥50%, less often among BPD patients given an AD (64.4%; 38.6% without switching into hypo/mania) than not (82.1%; 78.6% without switching).
  
  
  CONCLUSIONS
  Use of ADs to treat acute BP-depression was very common and associated with a more severe clinical history. Mood-switching was prevalent with AD-treatment even with mood-stabilizers present.
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Undurraga
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
authors.forename: Marc
authors.initials: M
authors.lastname: Valentí
authors.forename: Isabella
authors.initials: I
authors.lastname: Pacchiarotti
authors.forename: Leonardo
authors.initials: L
authors.lastname: Tondo
authors.forename: Gustavo
authors.initials: G
authors.lastname: Vázquez
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents