Which patients with bipolar depression receive antidepressant augmentation? Results from an observational multicenter study
| Autor: | Caterina Franceschini, Liliana Dell'Osso, Luca Proietti, Rocco de Filippis, Antonio Tundo, Laura Musetti, Claudia Del Grande, Erika Cambiali, Sophia Betrò, Donatella Marazziti |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Bipolar Disorder business.industry media_common.quotation_subject Antidepressive Agents Psychiatry and Mental health Mood Multicenter study Antimanic Agents Internal medicine Humans Antidepressive Agents Second-Generation Medicine Antidepressant Anticonvulsants In patient Observational study Temperament Neurology (clinical) Adverse effect business Depression (differential diagnoses) Antipsychotic Agents media_common |
| Zdroj: | CNS Spectrums. 27:731-739 |
| ISSN: | 2165-6509 1092-8529 |
| DOI: | 10.1017/s109285292100078x |
| Popis: | BackgroundTo identify demographic and clinical characteristics of bipolar depressed patients who require antidepressant (AD) augmentation, and to evaluate the short- and long-term effectiveness and safety of this therapeutic strategy.MethodsOne hundred twenty-two bipolar depressed patients were consecutively recruited, 71.7% of them received mood stabilizers (MS)/second-generation antipsychotics (SGA) with AD-augmentation and 28.3% did not. Patients were evaluated at baseline, and after 12 weeks and 15 months of treatment.ResultsThe AD-augmentation was significantly higher in patients with bipolar II compared with bipolar I diagnosis. Patients with MS/SGA + AD had often a seasonal pattern, depressive polarity onset, depressive index episode with anxious features, a low number of previous psychotic and (hypo)manic episodes and of switch. They had a low irritable premorbid temperament, a low risk of suicide attempts, and a low number of manic symptoms at baseline. After 12 weeks of treatment, 82% of patients receiving ADs improved, 58% responded and 51% remitted, 3.8% had suicidal thoughts or projects, 6.1% had (hypo)manic switch, and 4.1% needed hospitalization. During the following 12 months, 92% of them remitted from index episode, 25.5% did not relapse, and 11% needed hospitalization. Although at the start advantaged, patients with AD-augmentation, compared with those without AD-augmentation, did not significantly differ on any outcome as well on adverse events in the short- and long-term treatment.ConclusionOur findings indicate that ADs, combined with MS and/or SGA, are short and long term effective and safe in a specific subgroup for bipolar depressed patients. |
| Databáze: | OpenAIRE |
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