Antidepressant-associated maniform states in acute treatment of patients with bipolar-I depression

  title={Antidepressant-associated maniform states in acute treatment of patients with bipolar-I depression},
  author={Ronald Bottlender and Daniel Rudolf and Anton Strauss and Hans-J{\"u}rgen M{\"o}ller},
  journal={European Archives of Psychiatry and Clinical Neuroscience},
Abstract Medical records of 158 patients with bipolar depression were analysed for the incidence of a switch from depression to maniform states (mania and hypomania). Relation to psychopharmacological treatment was investigated. Thirty-nine (25%) patients of the total sample had switched to a maniform state during the treatment period in the hospital. Among that group the phenomenon occurred in 23 patients (15%) as a hypomania and in 16 patients (10%) as a mania. Patients with a switch were… 

Sociodemographic and Clinical Features of Antidepressant-Induced Hypomanic and Manic Switch in Patients with Bipolar Disorder

Two findings, cesarian birth and enuresis nocturna, may be significant in terms of suggesting clues for the planning of new studies illuminating the etiology of hypomanic/manic switch in patients whose first episode is a depressive one.

Antidepressant-associated switches from depression to mania in severe bipolar disorder.

In this sample of first-admission inpatients with severe BD, switching from depression to mania was not associated with AD treatment and respondents who experienced switching appeared to have a more relentless form of BD.

Evaluating the efficacy and safety of antidepressants in patients with bipolar disorder

The authors conclude that the real question is not whether ADs should or should not be used in bipolar depression, but which patients benefit from these drugs and which ones are impaired.

[Manic episodes during antidepressant treatment in bipolar disorder].

Antidepressants have been associated with an increased risk of inducing mania and this risk may vary according to the drug utilized, therefore antidepressants should be used in bipolar patients based on clinical efficacy as well as the potential effects on the course of the illness.

New Perspectives in the Acute Treatment of Bipolar Depression

  • H. GrunzeS. SchlösserJ. Walden
  • Psychology
    The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
  • 2000
In contrast to mania, bipolar depression is usually characterised by longer-lasting episodes and a higher incidence of treatment refractoriness, which means that the use of true antidepressants still appears to be mandatory, especially because of the risk of suicide.

Acute pharmacological treatment strategies for bipolar depression

In this review, the evidence base for available medication options, from antidepressants, lithium, anticonvulsants and antipsychotics as well as from other groups are explored.

Switching, Induction of Rapid Cycling, and Increased Suicidality With Antidepressants in Bipolar Patients: Fact or Overinterpretation?

It appears that, at least, the switch risk, and perhaps also the risk for rapid cycling and new-onset suicidality have been overinterpreted, and this raises doubt about the efficacy of anti-depressants as a primary-treatment choice in bipolar depression.



Bipolar depression and antidepressant-induced mania: a naturalistic study.

The frequency and severity of postdepressive mood elevation associated with acute or continuation antidepressant therapy may be reduced by mood stabilizers, which may be more likely in patients with a strong history of mania.

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  • R. Howland
  • Psychology, Medicine
    Journal of clinical psychopharmacology
  • 1996
Clinical information about 11 patients who developed mania during treatment with SRIs, found to have personal or family histories of hypomania or mania, but these disorders were not usually recognized at the time of the patients' initial treatment for depression.

Antidepressant-induced mania and cycle acceleration: a controversy revisited.

Antidepressant-induced mania may be a marker for increased vulnerability to antidepressant-induced cycle acceleration and is associated with younger age at first treatment and may be more likely to occur in women and in bipolar II patients.

Switch from depression to mania--a record study over decades between 1920 and 1982.

There is no evidence for a treatment-induced switch of unipolar or bipolar patients in Zurich over the decades, in line with Prien et al.

Tranylcypromine versus imipramine in anergic bipolar depression.

These findings provide further documentation of the utility of MAOIs in patients presenting with anergia, motor retardation, hyperphagia, and/or hypersomnia and propose that the apparently superior efficacy of tranylcypromine in bipolar depression is specifically linked to anergIA and reversed neurovegetative symptoms.

Lithium carbonate and imipramine in prevention of affective episodes. A comparison in recurrent affective illness.

With bipolar patients lithium carbonate was significantly more effective than imipramine or placebo in preventing affective episodes (ie, manic or depressive attacks severe enough to require hospitalization or use of nonstudy drugs).

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The authors reviewed the charts of3O bipolar patients taking lithium who were treated with tricvclic antidepressants and found that patients with a history of lithium-related mood disorders were more likely to be treated with antidepressants.

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  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 1980
Recent advances in biological psychiatry have provided the field with a raison d'être as a unique branch of psychological medicine. Many clinicians are understandably skeptical about the application

Psychiatric illness in family practice.

For the majority of "high distress" patients, pharmacotherapy was considered the treatment of choice by physicians, and high concordance existed between the "case" assessment by the physician and the patient's own rating of distress.