title: Efficacy and safety of fluoxetine monotherapy in bipolar depression: a systematic review.
abstract: BACKGROUND
  The treatment of depressive episodes in bipolar disorder (BD) remains a challenge for clinicians and is a hot topic in current psychiatric practice. In the present review, we focused on efficacy and safety of fluoxetine monotherapy in order to identify published randomized double-blind trials and open-label trials, written in English, reporting the outcome of fluoxetine treatment in depressed bipolar patients.
  
  
  METHODS
  We searched Pubmed to identify published randomized double-blind trials and open-label trials, written in English, reporting the results of fluoxetine treatment in depressed bipolar patients. The following key words were used: fluoxetine AND bipolar AND depression AND treatment. A total number of seven prospective studies (four randomized clinical trials and three open-label trials) and one two-phase retrospective study were reviewed.
  
  
  CONCLUSIONS
  Fluoxetine showed to be efficacious in bipolar depression, confirming its well-known activity in major depressive episodes, with a low percentage of mood switch, despite the general view that antidepressants may increase the rate of manic/hypomanic episodes in BDs. More studies with larger sample sizes, comparing fluoxetine with other antidepressants, mood stabilizers and antipsychotics are needed.
authors.affiliation: University G. d'Annunzio, Department of Neuroscience and Imaging, Chieti, Via del Vestini 33, 66013, Chieti. giovanni.martinotti@gmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.forename: Gianna
authors.initials: G
authors.lastname: Sepede
authors.forename: Maria
authors.initials: M
authors.lastname: Signorelli
authors.forename: Eugenio
authors.initials: E
authors.lastname: Aguglia
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000009:adverse effects; D001714:Bipolar Disorder / Q000188:drug therapy*; D005473:Fluoxetine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors