Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-20T17:22:45.011Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term prospective mood self-rating and antidepressant treatment

Published online by Cambridge University Press:  13 June 2014

Sumana Gadde ,
Carl Brown ,
Amy Shah  and
Rif S. El-Mallakh
Sumana Gadde
Affiliation:
Mood Disorders Research Programme, Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky, USA
Carl Brown
Affiliation:
Mood Disorders Research Programme, Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky, USA
Amy Shah
Affiliation:
Mood Disorders Research Programme, Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky, USA
Rif S. El-Mallakh
Affiliation:
Mood Disorders Research Programme, Department of Psychiatry, University of Louisville School of Medicine, Louisville, Kentucky, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

The use of antidepressants in bipolar illness remains controversial. This controversy continues to be fuelled by short-term studies that inconsistently report efficacy or no benefit. However, long-term studies have been consistently unfavourable, suggesting that understanding the long-term course of the illness in the setting of antidepressant treatment is important. This is an extraordinary case in which prospectively collected daily mood ratings were available in a type I bipolar individual who had experienced minimal medication changes over a 21-year period was reviewed. Data regarding the number of euthymic days in the setting of antidepressant use and after antidepressant discontinuation were collected.

Induction of cycling and increase in the number of depressed days occurred after five years of continuous serotonergic antidepressant administration. Discontinuation of antidepressants after 11 years of continuous use was associated with only a partial improvement which had a delayed onset. Cycling and increase in depression was noted after years of continuous use of serotonergic antidepressant treatment. Antidepressant-associated destabilisation may occur after long-term exposure and may be associated with prolonged worsening even after antidepressant discontinuation.

Keywords

AntidepressantsBipolar disorderLong-term outcomeRapid cycling
Type
Case reports
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 4 , December 2011 , pp. 227 - 229
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ghaemi, SN, Lenox, MS, Baldessarini, RJ. Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. J Clin Psychiatry 2001; 62: 565–569.CrossRefGoogle ScholarPubMed
2.Sachs, GS, Nierenberg, AA, Calabrese, JRet al.Effectiveness of adjunctive antidepressant treatment for bipolar depression. New Engl J Med 2007; 356: 1711–1722.CrossRefGoogle ScholarPubMed
3.Prien, RF, Kupfer, DJ, Mansky, PAet al.Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination. Arch Gen Psychiat 1984; 41: 1096–1104.CrossRefGoogle Scholar
4.Ghaemi, SN, Ostacher, MM, El-Mallakh, RSet al.A Randomised Clinical Trial of Long-Term Effectiveness and Safety of Modern Antidepressants combined with Mood-Stabilizers. J Clin Psychiatry (in press)Google Scholar
5.El-Mallakh, RS, Karippot, A. Chronic depression in bipolar disorder. Am J Psychiatry 2006; 163: 1137–1341.CrossRefGoogle ScholarPubMed
6.Altshuler, LL, Post, RM, Leverich, GS, et al.Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry 1995; 152: 1130–1138.Google ScholarPubMed
7.El-Mallakh, RS. An open study of methylphenidate in bipolar depression. Bipolar Disord 2000; 2: 56–59.CrossRefGoogle ScholarPubMed
9.Gijsman, HJ, Geddes, JR, Rendell, JMet al.Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiat 2004; 161: 1537–1547.CrossRefGoogle ScholarPubMed
10.Ghaemi, SN, Rosenquist, KJ, Ko, JYet al.Antidepressant treatment in bipolar versus unipolar depression. Am J Psychiat 2004; 161: 163–165.CrossRefGoogle ScholarPubMed
11.Rousseva, A, Henry, C, van den Bulke, Det al.Antidepressant-induced mania, rapid cycling and the serotonin transporter gene polymorphism. Pharmacogenomics J 2003; 3: 101–104.CrossRefGoogle ScholarPubMed
12.Lydon, E, El-Mallakh, RS. Naturalistic Long-term use of methylphenidate in bipolar disorder. J Clin Psychopharmacol 2006; 26(5): 516–518.CrossRefGoogle ScholarPubMed
13.Thase, ME, Macfadden, W, Weisler, RHet al.Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled study (the BOLDER II study). J Clin Psychopharmacol 2006; 26: 600–609.CrossRefGoogle Scholar
14.Post, RM, Altshuler, LL, Leverich, GSet al.Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. Br J Psychiatry 2006; 189: 124–131. (Erratum in: Br J Psychiatry 2006; 189: 569).CrossRefGoogle ScholarPubMed