Clinical features of antidepressant associated manic and hypomanic switches in bipolar disorder

Serretti, Alessandro; Artioli, Paola; Zanardi, Raffaella; Rossini, David

doi:10.1016/s0278-5846(03)00104-0

Cited by 34 publications

(45 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Still, caution is warranted in interpreting this finding, as confidence intervals for both antidepressant-treated and untreated patients cross one, indicating that we cannot exclude the possibility of no effect in either group. Among other previously reported risk factors, for age, we observed greatest risk among younger rather than older patients, in contrast to some prior descriptions (Serretti et al, 2003;Tamada et al, 2004).…”

Section: Discussioncontrasting

confidence: 99%

“…Taking these studies together, the most consistent predictor identified has been bipolar I status (Bond et al, 2008, Serretti et al, 2003; although we identified a numerically greater risk in this group (HR 1.17, 95% CI 0.95-1.45), it did not reach statistical significance. Identification of a statistically significant treatment-by-predictor interaction suggested that, among antidepressant-treated but not -untreated patients, bipolar 1 status is associated with greater switch risk.…”

Section: Discussionmentioning

confidence: 59%

“…In one, risk factors among 416 bipolar patients included older age, absence of delusions, depressive onset, fewer manic episodes, and bipolar I subtype (Serretti et al, 2003). In a matched case-control study including 24 patients, risk factors included being older and having a longer duration of illness and more previous episodes (Tamada et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transition to Mania During Treatment of Bipolar Depression

Perlis

Ostacher

Goldberg

et al. 2010

Neuropsychopharmacol

View full text Add to dashboard Cite

Some individuals with bipolar disorder transition directly from major depressive episodes to manic, hypomanic, or mixed states during treatment, even in the absence of antidepressant treatment. Prevalence and risk factors associated with such transitions in clinical populations are not well established, and were examined in the Systematic Treatment Enhancement Program for Bipolar Disorder study, a longitudinal cohort study. Survival analysis was used to examine time to transition to mania, hypomania, or mixed state among 2166 bipolar I and II individuals in a major depressive episode. Cox regression was used to examine baseline clinical and sociodemographic features associated with hazard for such a direct transition. These features were also examined for interactive effects with antidepressant treatment. In total, 461/2166 subjects in a major depressive episode (21.3%) transitioned to a manic/hypomanic or mixed state before remission, including 289/1475 (19.6%) of those treated with antidepressants during the episode. Among the clinical features associated with greatest transition hazard were greater number of past depressive episodes, recent or lifetime rapid cycling, alcohol use disorder, previous suicide attempt, and history of switch while treated with antidepressants. Greater manic symptom severity was also associated with risk for manic transition among both antidepressant-treated and antidepressant-untreated individuals. Three features, history of suicide attempt, younger onset age, and bipolar subtype, exhibited differential effects between individuals treated with antidepressants and those who were not. These results indicate that certain clinical features may be associated with greater risk of transition from depression to manic or mixed states, but the majority of them are not specific to antidepressant-treated patients.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transition to Mania During Treatment of Bipolar Depression

Perlis

Ostacher

Goldberg

et al. 2010

Neuropsychopharmacol

View full text Add to dashboard Cite

show abstract

“…Sensitivity and specificity of our model for antidepressant-association predictors were high. Some studies indicated that a BDI diagnosis [37,38,39], a positive history of suicide attempts possibly related to patient impulsiveness [37], higher YMRS scores on the disruptive behavior item [37], and excitatory symptoms (motor activation, pressured speech, and racing thoughts) [40] increase antidepressant-associated switch-risk. There is contrasting evidence about the role of age [37,38,41].…”

Section: Discussionmentioning

confidence: 99%

“…However, data on this topic are limited [7,33,34,35,36]. Furthermore, few studies have focused on characteristics that make patients more susceptible to antidepressant-associated MxD (AD-MxD) [37,38,39,40,41,42]; finally, no study heretofore has investigated the antidepressant-associated transition from depression to MxD.…”

Section: Introductionmentioning

confidence: 99%

Mixed Depression: Clinical Features and Predictors of Its Onset Associated with Antidepressant Use

Sani¹,

Napoletano

Vöhringer

et al. 2014

Psychother Psychosom

View full text Add to dashboard Cite

Background: Mixed depression (MxD) is narrowly defined in the DSM-IV and somewhat broader in the DSM-5, although both exclude psychomotor agitation as a diagnostic criterion. This article proposes a clinical description for defining MxD, which emphasizes psychomotor excitation. Methods: Two hundred and nineteen consecutive outpatients were diagnosed with an MxD episode using criteria proposed by Koukopoulos et al. [Acta Psychiatr Scand 2007;115(suppl 433):50-57]; we here report their clinical features and antidepressant-related effects. Results: The most frequent MxD symptoms were: psychic agitation or inner tension (97%), absence of retardation (82%), dramatic description of suffering or weeping spells (53%), talkativeness (49%), and racing or crowded thoughts (48%). MxD was associated with antidepressants in 50.7% of patients, with similar frequency for tricyclic antidepressants (45%) versus selective serotonin reuptake inhibitors (38.5%). Positive predictors of antidepressant-associated MxD were bipolar disorder type II diagnosis, higher index depression severity, and higher age at index episode. Antipsychotic or no treatment was protective against antidepressant-associated MxD. Conclusions: MxD, defined as depression with excitatory symptoms, can be clinically identified, is common, occurs in both unipolar depression and bipolar disorder, and is frequently associated with antidepressant use. If replicated, this view of MxD could be considered a valid alternative to the DSM-5 criteria for depression with mixed features.

show abstract

Genetic features of antidepressant induced mania and hypo-mania in bipolar disorder

et al. 2004

Self Cite

View full text Add to dashboard Cite

The distribution of the genetic polymorphisms was not significantly different between switched and not-switched patients ( P>0.006-Bonferroni corrected). Moreover, no significant difference was found between switched and not switched sub-samples and the sample of major depressed subjects. Further studies are required to investigate other possible related genetic variants influencing the timing of manic-depressive cycle.

show abstract

Clinical features of antidepressant associated manic and hypomanic switches in bipolar disorder

Cited by 34 publications

References 47 publications

Transition to Mania During Treatment of Bipolar Depression

Transition to Mania During Treatment of Bipolar Depression

Mixed Depression: Clinical Features and Predictors of Its Onset Associated with Antidepressant Use

Genetic features of antidepressant induced mania and hypo-mania in bipolar disorder

Contact Info

Product

Resources

About