Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Visser, H M; Mast, Roos C. van der

doi:10.1080/15622970510029885

Cited by 43 publications

(22 citation statements)

References 36 publications

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“…Monotherapy with modern antidepressants also persisted longer (a median of 21.9-43.6 weeks) than any other treatment except lithium (39.1-58.3 weeks) (Table 4). High rates of antidepressant use among patients with bipolar disorder also have been noted in other recent American studies (18)(19)(20)26,27,29,31,34,35). Such treatment contributes substantially to the cost of care for patients with bipolar disorder (26) and carries risks of adverse clinical effects (7,18,19), although quantitative risks of inducing mania or mood destabilization remain uncertain among patients with bipolar I disorder (34) and may be more limited among patients with bipolar II disorder (35).…”

Section: Discussionmentioning

confidence: 75%

Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders

Baldessarini¹,

Leahy²,

Arcona³

et al. 2007

228

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Section: Discussionmentioning

confidence: 75%

Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders

Baldessarini¹,

Leahy²,

Arcona³

et al. 2007

228

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“…Use of antidepressants during pregnancy, especially after discontinuing mood stabilizers, may have exerted mood-destabilizing effects (36)(37)(38)(39). Alternatively, antidepressant use during pregnancy may reflect the presence of bipolar II disorder patients, who are often treated with antidepressants, or may simply be an indicator for more severe illness (40)(41)(42).…”

Section: Recurrence Of Bipolar Disorder In Pregnancymentioning

confidence: 99%

Risk of Recurrence in Women With Bipolar Disorder During Pregnancy: Prospective Study of Mood Stabilizer Discontinuation

Viguera¹,

Whitfield²,

Baldessarini³

et al. 2007

AJP

508

267

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Discontinuation of mood stabilizer, particularly abruptly, during pregnancy carries a high risk for new morbidity in women with bipolar disorder, especially for early depressive and dysphoric states. However, this risk is reduced markedly by continued mood stabilizer treatment. Treatment planning for pregnant women with bipolar disorder should consider not only the relative risks of fetal exposure to mood stabilizers but also the high risk of recurrence and morbidity associated with stopping maintenance mood stabilizer treatment.

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“…On the other hand, there has been consensus about the higher risk of inducing mania or hypomania during treatment with TCA than with non-TCA drugs [9] . Peet [10] has shown that in bipolar patients manic switches occurred substantially more often with TCAs than with selective serotonin re-uptake inhibitors (SSRIs) or placebo (11.2 vs. 3.7 vs. 4.2%).…”

Section: Introductionmentioning

confidence: 99%

Antidepressant-Induced Mood Conversions in Bipolar Disorder: A Retrospective Study of Tricyclic versus Non-Tricyclic Antidepressant Drugs

Koszewska

Rybakowski

2009

Neuropsychobiology

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Objectives: The aim of this retrospective study was an analysis of antidepressant-induced mood conversions to mania/hypomania occurring in bipolar inpatients treated with antidepressants in the Affective Disorder Unit of the Institute of Psychiatry and Neurology, Warsaw, in the years 1972–1996. Methods: The data for analysis were obtained retrospectively from clinical records. In a subgroup of patients prone to mood conversions, a comparison was done of depressive episodes treated with antidepressants with and without a switch to mania/hypomania as well as the frequency of mood conversions induced by particular antidepressant drugs, especially tricyclic (TCA) versus non-TCA drugs. Results: Among 333 bipolar patients hospitalized in this period, mood conversions were observed in 118 subjects, significantly more frequently in female (44%) than in male patients (25%), and in patients with depressive episode at the onset of illness (80 vs. 40%). Among mood converters, it was found that the depressive episodes with a switch to mania were less severe, shorter, and with shorter duration of antidepressant treatment. The risk of switching was higher during treatment with TCA than with non-TCA drugs (36 vs. 17%), the highest with amitriptyline (42% of treated episodes), imipramine (40%) and clomipramine (35%). Conclusions: Our results suggest that bipolar patients prone to mood conversion constitute one third of the inpatient population with this illness. The switch from depression to mania occurred significantly more frequently during treatment with TCA than with non-TCA drugs. It is hypothesized that anticholinergic activity may contribute to the higher frequency of TCA-induced mood conversions.

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Bipolar disorder, antidepressants and induction of hypomania or mania. A systematic review

Abstract: There is an urgent need for adequate studies of sufficient size. For the time being, treatment of bipolar depression may best be based on the results of the life chart of the individual patient keeping in mind the risk factors found until now.

Cited by 43 publications

References 36 publications

Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders

Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders

Risk of Recurrence in Women With Bipolar Disorder During Pregnancy: Prospective Study of Mood Stabilizer Discontinuation

Antidepressant-Induced Mood Conversions in Bipolar Disorder: A Retrospective Study of Tricyclic versus Non-Tricyclic Antidepressant Drugs

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