Abstract | OBJECTIVE: METHOD:
Antidepressant treatment histories were examined from intake assessments for the first 500 subjects enrolled into the STEP-BD between November 1999 and November 2000. Affective switch was defined as a report of mania, hypomania, or mixed episodes within the first 12 weeks of having started an antidepressant. Demographic and clinical characteristics were compared for subjects with or without a history of acute switch during antidepressant treatment. RESULTS: Among the 338 subjects with prior antidepressant treatment and complete data on switch event outcomes, 44% reported at least 1 such occurrence. Patients with a shorter duration of illness (odds ratio [OR] = 1.02, 95% CI = 1.01 to 1.04) and a history of multiple antidepressant trials (OR = 1.73, 95% CI = 1.38 to 2.16) were more likely to report a history of switch than other patients. A significantly increased risk for affective polarity switch was identified in patients who had ever switched to mania/ hypomania while taking tricyclic antidepressants (OR = 7.80, 95% CI = 1.56 to 28.9), serotonin reuptake inhibitors (OR = 3.73, 95% CI = 1.98 to 7.05), or bupropion (OR = 4.28, 95% CI = 1.72 to 10.6). Switch was less common during treatment with electroconvulsive therapy or monoamine oxidase inhibitors than other antidepressants. CONCLUSIONS:
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Authors | Christine J Truman, Joseph F Goldberg, S Nassir Ghaemi, Claudia F Baldassano, Stephen R Wisniewski, Ellen B Dennehy, Michael E Thase, Gary S Sachs |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 68
Issue 10
Pg. 1472-9
(Oct 2007)
ISSN: 1555-2101 [Electronic] United States |
PMID | 17960960
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Antidepressive Agents
(therapeutic use)
- Bipolar Disorder
(diagnosis, drug therapy, epidemiology)
- Cohort Studies
- Demography
- Diagnostic and Statistical Manual of Mental Disorders
- Disclosure
- Drug Monitoring
- Electronic Data Processing
- Female
- Humans
- Male
- Prevalence
- Registries
- Severity of Illness Index
- Surveys and Questionnaires
- Treatment Outcome
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