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Do antidepressants influence mood patterns? A naturalistic study in bipolar disorder

Published online by Cambridge University Press:  16 April 2020

M. Bauer ,
N. Rasgon ,
P. Grof ,
T. Glenn ,
M. Lapp ,
W. Marsh ,
R. Munoz ,
A. Suwalska ,
C. Baethge  and
T. Bschor
...Show all authors
M. Bauer*
Affiliation:
Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlin, Germany Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
N. Rasgon
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA Department of Psychiatry, Stanford School of Medicine, Palo Alto, CA, USA
P. Grof
Affiliation:
Mood Disorders Clinic of Ottawa, Ottawa, Canada
T. Glenn
Affiliation:
ChronoRecord Association, Inc. (www.chronorecord.org), Fullerton, CA, USA
M. Lapp
Affiliation:
Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlin, Germany
W. Marsh
Affiliation:
Department of Psychiatry, Stanford School of Medicine, Palo Alto, CA, USA
R. Munoz
Affiliation:
Department of Psychiatry, University of California San Diego, San Diego, CA, USA
A. Suwalska
Affiliation:
Department of Psychiatry, Karol Marcinkowski University of Medical Science, Poznan, Poland
C. Baethge
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
T. Bschor
Affiliation:
Department of Psychiatry and Psychotherapy, Jewish Hospital of Berlin, Berlin, Germany
M. Alda
Affiliation:
Department of Psychiatry, McGill University, Montreal, Quebec, Canada
P.C. Whybrow
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
*
*Corresponding author. E-mail address: michael.bauer@charite.de (M. Bauer).
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Abstract

This prospective, longitudinal study compared the frequency and pattern of mood changes between outpatients receiving usual care for bipolar disorder who were either taking or not taking antidepressants. One hundred and eighty-two patients with bipolar disorder self-reported mood and psychiatric medications for 4 months using a computerized system (ChronoRecord) and returned 22,626 days of data. One hundred and four patients took antidepressants, 78 did not. Of the antidepressants taken, 95% were selective serotonin or norepinephrine reuptake inhibitors, or second-generation antidepressants. Of the patients taking an antidepressant, 91.3% were concurrently taking a mood stabilizer. The use of antidepressants did not influence the daily rate of switching from depression to mania or the rate of rapid cycling, independent of diagnosis of bipolar I or II. The primary difference in mood pattern was the time spent normal or depressed. Patients taking antidepressants frequently remained in a subsyndromal depression. In this naturalistic study using self-reported data, patients with bipolar disorder who were taking antidepressants—overwhelmingly not tricyclics and with a concurrent mood stabilizer—did not experience an increase in the rate of switches to mania or rapid cycling compared to those not taking antidepressants. Antidepressants had little impact on the mood patterns of bipolar patients taking mood stabilizers.

Keywords

Bipolar disorderAntidepressantsManiaRapid cyclingSwitchMood stabilizer
Type
Original articles
Information
European Psychiatry , Volume 21 , Issue 4 , June 2006 , pp. 262 - 269
Copyright
Copyright © European Psychiatric Association 2006

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References

Akiskal, HS, Bourgeois, ML, Angst, J, Post, R, Moller, H, Hirschfeld, RRe-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J. Affect. Disord. 2000;59(Suppl 1):S5–S30.CrossRefGoogle ScholarPubMed
Altshuler, LL, Post, RM, Leverich, GS, Mikalauskas, K, Rosoff, A, Ackerman, LAntidepressant-induced mania and cycle acceleration: a controversy revisited. Am. J. Psychiatry 1995;152:1130–1138.Google ScholarPubMed
Altshuler, L, Kiriakos, L, Calcagno, J, Goodman, R, Gitlin, M, Frye, Met al.The impact of antidepressant discontinuation vs. antidepressant continuation on 1-year risk for relapse of bipolar depression: a retrospective chart review. J. Clin. Psychiatry 2001;62:612–616.CrossRefGoogle Scholar
Altshuler, L, Suppes, T, Black, D, Nolen, WA, Keck, PE Jr., Frye, MAet al.Impact of antidepressant discontinuation after acute bipolar depression remission on rates of depressive relapse at 1-year follow-up. Am. J. Psychiatry 2003;160:1252–1262.CrossRefGoogle ScholarPubMed
Altshuler, LL, Suppes, T, Black, DO, Nolen, WA, Leverich, G, Keck, PE Jr.et al.Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants. Am. J. Psychiatry 2006;163:313–315.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Practice Guideline for the Treatment of Patients with Bipolar Diosrder, April 2002. Available at: http://www.psych.org/psych_pract/treatg/pg/bipolar_revisebook_index.cfm.Google Scholar
Andrade, C, Gangadhar, BN, Swaminath, G, Channabasavanna, SMMania as a side effect of electroconvulsive therapy. Convuls. Ther. 1988;4:81–83.Google ScholarPubMed
Angst, JSwitch from depression to mania- a record study over decades between 1920 and 1982. Psychopathology 1985;18:140–154.CrossRefGoogle Scholar
Angst, J, Angst, K, Baruffol, I, Meinherz-Surbeck, RECT-Induced and drug-induced hypomania. Convuls. Ther. 1992;8:179–185.Google ScholarPubMed
Angst, J, Gamma, AA new bipolar spectrum concept: a brief review. Bipolar Disord. 2002;4(Suppl 1):11–14.CrossRefGoogle ScholarPubMed
Arana, GW, Pearlman, C, Shader, RIAlprazolam-induced mania: two clinical cases. Am. J. Psychiatry 1985;142:368–369.Google ScholarPubMed
Bauer, M, Grof, P, Gyulai, L, Rasgon, N, Glenn, T, Whybrow, PCUsing technology to improve longitudinal studies: self-reporting in bipolar disorder. Bipolar Disord. 2004;6:67–74.CrossRefGoogle ScholarPubMed
Bauer, M, Rasgon, N, Grof, P, Altshuler, L, Gyulai, L, Lapp, Met al.Mood changes related to antidepressants: a longitudinal study of patients with bipolar disorder in a naturalistic setting. Psychiatry Res. 2005;133:73–80.CrossRefGoogle Scholar
Bauer, M, Neuhaus, K, Sasse, J, Schlosser, T, Bschor, T, Rasgon, N, et al. Validation of ChronoRecord Self-Reporting Software by Inpatients with Mania. Atlanta, GA: American Psychiatric Association Annual Meeting, New Research Poster Session; 2005.Google Scholar
Bauer, MS, Crits-Christoph, P, Ball, WA, Dewees, E, McAllister, T, Alahi, Pet al.Independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania. Arch. Gen. Psychiatry 1991;48:807–812.CrossRefGoogle Scholar
Benazzi, FPrevalence and clinical correlates of residual depressive symptoms in bipolar II disorder. Psychother. Psychosom. 2001;70:232–238.CrossRefGoogle ScholarPubMed
Boerlin, HL, Gitlin, MJ, Zoellner, LA, Hammen, CLBipolar depression and antidepressant-induced mania: a naturalistic study. J. Clin. Psychiatry 1998;59:374–379.CrossRefGoogle ScholarPubMed
Bottlender, R, Rudolf, D, Strauss, A, Moller, HJAntidepressant-associated maniform states in acute treatment of patients with bipolar-I depression. Eur. Arch. Psychiatry Clin. Neurosci. 1998;248:296–300.CrossRefGoogle ScholarPubMed
Colombo, C, Benedetti, F, Barbini, B, Campori, E, Smeraldi, ERate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression. Psychiatry Res. 1999;86:267–270.CrossRefGoogle ScholarPubMed
Coryell, W, Endicott, J, Keller, MRapidly cycling affective disorder. Demographics, diagnosis, family history, and course. Arch. Gen. Psychiatry 1992;49:126–131.CrossRefGoogle ScholarPubMed
Denicoff, KD, Smith-Jackson, EE, Disney, ER, Suddath, RL, Leverich, GS, Post, RMPreliminary evidence of the reliability and validity of the prospective life-chart methodology (LCM-p). J. Psychiatr. Res. 1997;31:593–603.CrossRefGoogle Scholar
Ghaemi, SN, Hsu, DJ, Soldani, F, Goodwin, FKAntidepressants in bipolar disorder: the case for caution. Bipolar Disord. 2003;5:421–433.CrossRefGoogle ScholarPubMed
Gijsman, HJ, Geddes, JR, Rendell, JM, Nolen, WA, Goodwin, GMAntidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am. J. Psychiatry 2004;161:1537–1547.CrossRefGoogle ScholarPubMed
Goldberg, JF, Whiteside, JEThe association between substance abuse and antidepressant-induced mania in bipolar disorder: a preliminary study. J. Clin. Psychiatry 2002;63:791–795.CrossRefGoogle ScholarPubMed
Goodwin, FK, Jamison, KRManic Depressive Illness New York: Oxford University Press; 1990.Google Scholar
Grunhaus, L, Rabin, D, Greden, JFSimultaneous panic and depressive disorder: response to antidepressant treatments. J. Clin. Psychiatry 1986;47:4–7.Google ScholarPubMed
Hausmann, A, Kramer-Reinstadler, K, Lechner-Schoner, T, Walpoth, M, Rupp, CI, Hinterhuber, Het al.Can bilateral prefrontal repetitive transcranial magnetic stimulation (rTMS) induce mania? A case report. J. Clin. Psychiatry 2004;65:1575–1576.CrossRefGoogle ScholarPubMed
Henry, C, Sorbara, F, Lacoste, J, Gindre, C, Leboyer, MAntidepressant-induced mania in bipolar patients: identification of risk factors. J. Clin. Psychiatry 2001;62:249–255.CrossRefGoogle ScholarPubMed
Howland, RHInduction of mania with serotonin reuptake inhibitors. J. Clin. Psychopharmacol. 1996;16:425–427.CrossRefGoogle ScholarPubMed
Jackson, A, Cavanagh, J, Scott, JA systematic review of manic and depressive prodromes. J. Affect. Disord. 2003;74:209–217.CrossRefGoogle ScholarPubMed
Judd, LL, Akiskal, HS, Schettler, PJ, Endicott, J, Maser, J, Solomon, DAet al.The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch. Gen. Psychiatry 2002;59:530–537.CrossRefGoogle ScholarPubMed
Keitner, GI, Solomon, DA, Ryan, CE, Miller, IW, Mallinger, A, Kupfer, DJet al.Prodromal and residual symptoms in bipolar I disorder. Compr. Psychiatry 1996;37:362–367.CrossRefGoogle ScholarPubMed
Leverich, GS, Altshuler, LL, Frye, MA, Suppes, T, McElroy, SL, Keck, PE Jr.et al.Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am. J. Psychiatry 2006;163:232–239.CrossRefGoogle ScholarPubMed
Lewis, JL, Winkour, GThe induction of mania. A natural history with controls. Arch. Gen. Psychiatry 1982;39:303–306.CrossRefGoogle Scholar
Mundo, E, Walker, M, Cate, T, Macciardi, F, Kennedy, JLThe role of serotonin transporter protein gene in antidepressant-induced mania in bipolar disorder: preliminary findings. Arch. Gen. Psychiatry 2001;58:539–544.CrossRefGoogle ScholarPubMed
Post, RM, Leverich, GS, Nolen, WA, Kupka, RW, Altshuler, LL, Frye, MAStanley Foundation Bipolar Network. A re-evaluation of the role of antidepressants in the treatment of bipolar depression: data from the Stanley Foundation Bipolar Network. Bipolar Disord. 2003;5:396–406.CrossRefGoogle ScholarPubMed
Preda, A, MacLean, RW, Mazure, CM, Bowers, MB Jr.Antidepressant-associated mania and psychosis resulting in psychiatric admissions. J. Clin. Psychiatry 2001;62:30–33.CrossRefGoogle ScholarPubMed
Rachid, F, Bertschy, G, Bondolfi, G, Aubry, JMPossible induction of mania or hypomania by atypical antipsychotics: an updated review of reported cases. J. Clin. Psychiatry 2004;65:1537–1545.CrossRefGoogle ScholarPubMed
Rasgon, NL, Bauer, M, Grof, P, Gyulai, L, Elman, S, Glenn, TSex-specific self-reported mood changes by patients with bipolar disorder. J. Psychiatr. Res. 2005;39:77–83.CrossRefGoogle ScholarPubMed
Reich, JThe effect of Axis II disorders on the outcome of treatment of anxiety and unipolar depressive disorders: a review. J. Personal. Disord. 2003;17:387–405.CrossRefGoogle ScholarPubMed
Riemann, D, Voderholzer, U, Berger, MSleep and sleep–wake manipulations in bipolar depression. Neuropsychobiology 2002;45(Suppl 1):7–12.CrossRefGoogle ScholarPubMed
Rouillon, F, Gorwood, PThe use of lithium to augment antidepressant medication. J. Clin. Psychiatry 59Suppl 51998 32–39.Google ScholarPubMed
Sachs, GS, Printz, DJ, Kahn, DA, Carpenter, D, Docherty, JPThe Expert Consensus Guideline Series: medication treatment of bipolar disorder 2000. Postgrad. Med. 2000 1–104 (Spec No).Google ScholarPubMed
Sakkas, P, Mihalopoulou, P, Mourtzouhou, P, Psarros, C, Masdrakis, V, Politis, Aet al.Induction of mania by rTMS: report of two cases. Eur. Psychiatry 2003;18:196–198.CrossRefGoogle ScholarPubMed
Sato, T, Sakado, K, Sato, S, Morikawa, TCluster a personality disorder: a marker of worse treatment outcome of major depression?. Psychiatry Res. 1994;53:153–159.CrossRefGoogle Scholar
Serretti, A, Artioli, P, Zanardi, R, Lorenzi, C, Rossini, D, Cusin, Cet al.Genetic features of antidepressant induced mania and hypo-mania in bipolar disorder. Psychopharmacology (Berl.) 2004;174:504–511.CrossRefGoogle ScholarPubMed
Stoll, AL, Mayer, PV, Kolbrener, M, Goldstein, E, Suplit, B, Lucier, Jet al.Antidepressant-associated mania: a controlled comparison with spontaneous mania. Am. J. Psychiatry 1994;151:1642–1645.Google ScholarPubMed
Tamada, RS, Issler, CK, Amaral, JA, Sachs, GS, Lafer, BTreatment emergent affective switch: a controlled study. Bipolar Disord. 2004;6:333–337.CrossRefGoogle ScholarPubMed
Wehr, TA, Goodwin, FKRapid cycling in manic-depressives induced by tricyclic antidepressants. Arch. Gen. Psychiatry 1979;36:555–559.CrossRefGoogle ScholarPubMed
Wehr, TA, Goodwin, FKCan antidepressants cause mania and worsen the course of affective illness?. Am. J. Psychiatry 1987;144:1403–1411.Google ScholarPubMed
Young, LT, Joffe, RT, Robb, JC, MacQueen, GM, Marriott, M, Patelis-Siotis, IDouble-blind comparison of addition of a second mood stabilizer vs. an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression. Am. J. Psychiatry 2000;157:124–126.CrossRefGoogle Scholar
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