title: Efficacy and mood conversion rate during long-term fluoxetine v. lithium monotherapy in rapid- and non-rapid-cycling bipolar II disorder.
abstract: BACKGROUND
  Controversy exists over antidepressant use in rapid-cycling bipolar disorder.
  
  
  OBJECTIVE
  Exploratory analysis of safety and efficacy of fluoxetine v. lithium monotherapy in individuals with rapid- v. non-rapid-cycling bipolar II disorder.
  
  
  METHODS
  Randomised, double-blind, placebo-controlled comparison of fluoxetine v. lithium monotherapy in patients initially stabilised on fluoxetine monotherapy (trial registration NCT00044616).
  
  
  RESULTS
  The proportion of participants with depressive relapse was similar between the rapid- and non-rapid-cycling groups (P = 0.20). The odds of relapse were similar between groups (P = 0.36). The hazard of relapse was similar between groups (hazard ratio 0.87, 95% CI 0.40-1.91). Change in mania rating scores was similar between groups (P = 0.86). There was no difference between groups in the rate of syndromal (P = 0.27) or subsyndromal (P = 0.82) hypomania.
  
  
  CONCLUSIONS
  Depressive relapse and treatment-emergent mood conversion episode rates were similar for lithium and fluoxetine monotherapy and placebo during long-term, relapse-prevention therapy of rapid- and non-rapid-cycling bipolar II disorder.
authors.affiliation: Depression Research Unit, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. jamsterd@mail.med.upenn.edu
authors.forename: Jay D
authors.initials: JD
authors.lastname: Amsterdam
authors.forename: Lola
authors.initials: L
authors.lastname: Luo
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D055502:Secondary Prevention; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D018020:Lithium Compounds; D005473:Fluoxetine