Switch Rates During Acute Treatment for Bipolar II Depression With Lithium, Sertraline, or the Two Combined: A Randomized Double-Blind Comparison.

Autor:	Altshuler, Lori L., Sugar, Catherine A., Mcelroy, Susan L., Calimlim, Brian, Gitlin, Michael, Keck, Paul E., Aquino-Elias, Ana, Martens, Brian E., Fischer, E. Grace, English, Teri L., Roach, Janine, Suppes, Trisha, Keck, Paul E Jr
Předmět:	BIPOLAR disorder THERAPEUTIC use of lithium SERTRALINE HYPOMANIA DRUG side effects PHYSIOLOGY THERAPEUTICS DIAGNOSIS of bipolar disorder AFFECT (Psychology) COMBINATION drug therapy COMPARATIVE studies RESEARCH methodology MEDICAL cooperation PSYCHOLOGICAL tests RESEARCH EVALUATION research RANDOMIZED controlled trials RELATIVE medical risk TREATMENT effectiveness BLIND experiment PATIENT dropouts LITHIUM carbonate PSYCHOLOGY
Zdroj:	American Journal of Psychiatry; Mar2017, Vol. 174 Issue 3, p266-276, 11p
Abstrakt:	Objective: The authors compared medication-induced mood switch risk (primary outcome), as well as treatment response and side effects (secondary outcomes) with three acute-phase treatments for bipolar II depression.Method: In a 16-week, double-blind, multisite comparison study, 142 participants with bipolar II depression were randomly assigned to receive lithium monotherapy (N=49), sertraline monotherapy (N=45), or combination treatment with lithium and sertraline (N=48). At each visit, mood was assessed using standardized rating scales. Rates of switch were compared, as were rates of treatment response and the presence and severity of treatment-emergent side effects.Results: Twenty participants (14%) experienced a switch during the study period (hypomania, N=17; severe hypomania, N=3). Switch rates did not differ among the three treatment groups, even after accounting for dropout. No patient had a manic switch or was hospitalized for a switch. Most switches occurred within the first 5 weeks of treatment. The treatment response rate for the overall sample was 62.7% (N=89), without significant differences between groups after accounting for dropout. The lithium/sertraline combination group had a significantly higher overall dropout rate than the monotherapy groups but did not have an accelerated time to response.Conclusions: Lithium monotherapy, sertraline monotherapy, and lithium/sertraline combination therapy were associated with similar switch and treatment response rates in participants with bipolar II depression. The dropout rate was higher in the lithium/sertraline combination treatment group, without any treatment acceleration advantage. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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