Double-blind comparison of addition of acanthopanax senticosus versus fluoxetine to lithium for treatment of adolescent patients with bipolar depression

Abstract

Bachground

Adolescents with bipolar disorder are much more than people once thought. Although there have been multiple reports published regarding the treatment of manic symptoms in children and adolescents, albeit mostly open studies, the efficacy of agents to treat bipolar depression in this population has not been adequately studied. Treating with antidepressants such as tricyclic antidepressants and SSRI(selective serotonin reuptake inhibitors) should face the risk of mood switching and suicide. Acanthopanax senticosus has shown some antidepressant effect since the ancient china, and preliminary studies also indicated it may be helpful to depression. Will it be helpful if treating the adolescent bipolar disorder?

Method:

76 patients were randomized into two groups, 37 treated with capsule Acanthopanax senticosus plus tablet lithium, 39 treated with capsule fluoxetine plus tablet lithium. Hamilton depression rating scale, 17 items (HAMD-17) was assessed during the trial.

Result

After 6 weeks treatment, There was a main effect for duration of treatment for Hamilton depression scale scores (F=183.06, P<0.01), but there was no group main effect(F=0.99, P=0.323) or group-by-duration of treatment interaction(F=0.779, P=0.437). The response rate and remission rate between the two group were similar. 3 patients suffered mood switching in fluoxetine treated group while no patients in Acanthopanax senticosus treated group.

Conclusion:

This preliminary study suggested that lithium adding Acanthopanax senticosus was as effective as lithium adding fluoxetine for treating adolescent bipolar depression, and Acanthopanax senticosus may be more safer and less risk to mood switching.