If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle acceleration

$48.00 plus tax (Refund Policy)

Download / Buy Article:

Abstract:

Licht RW, Gijsman H, Nolen WA, Angst J. Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle acceleration. Objective: 

To address whether switch of depression into hypomania or mania or cycle acceleration in patients with bipolar disorder is caused by antidepressants or whether this phenomenon is attributable to the natural history of bipolar disorder itself. Method: 

A critical review of the literature, pointing at sources of bias that have been previously overlooked. For examining the causation in question, the Bradford–Hill criteria were applied, i.e. specificity of the potential causative agent, strength of effect, consistency in findings, dose–response relation, temporal relation with exposure to agent preceding effect and biological plausibility. Results: 

There is a scarcity of randomized studies addressing the question, and the available studies all suffer from various forms of bias. However, there is some evidence suggesting that antidepressants given in addition to a mood stabilizer are not associated with an increased rate of switch when compared with the rate associated with the mood stabilizer alone. Conclusion: 

When combined with a mood stabilizer, antidepressants given for acute bipolar depression seemingly do not induce a switch into hypomania or mania. Whether antidepressants may accelerate episode frequency and/or may cause other forms of destabilization in patients with bipolar disorder remain to be properly studied.

Keywords: adverse effects; antidepressive agents; bipolar disorder; hypomania; mania

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2008.01237.x

Affiliations: 1: Mood Disorders Research Unit, Aarhus University Hospital, Risskov, Denmark 2: Stichting Forum GGZ Nijmegen and Department of Psychiatry, University Medical Centre Nijmegen, Nijmegen, the Netherlands 3: Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands 4: Zurich University Psychiatric Hospital, Zurich, Switzerland

Publication date: November 1, 2008

Related content

Tools

Favourites

Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more