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Efficacy and mood conversion rate during long-term fluoxetine v. lithium monotherapy in rapid- and non-rapid-cycling bipolar II disorder

  • Jay D. Amsterdam (a1), Lola Luo (a2) and Justine Shults (a2)
Abstract
Background

Controversy exists over antidepressant use in rapid-cycling bipolar disorder.

Aims

Exploratory analysis of safety and efficacy of fluoxetine v. lithium monotherapy in individuals with rapid- v. non-rapid-cycling bipolar II disorder.

Method

Randomised, double-blind, placebo-controlled comparison of fluoxetine v. lithium monotherapy in patients initially stabilised on fluoxetine monotherapy (trial registration NCT0O044616).

Results

The proportion of participants with depressive relapse was similar between the rapid- and non-rapid-cycling groups (P=0.20). The odds of relapse were similar between groups (P=0.36). The hazard of relapse was similar between groups (hazard ratio 0.87, 95% CI 0.40-1.91). Change in mania rating scores was similar between groups (P=0.86). There was no difference between groups in the rate of syndromal (P-0.27) or subsyndromal (P=0.82) hypomania.

Conclusions

Depressive relapse and treatment-emergent mood conversion episode rates were similar for lithium and fluoxetine monotherapy and placebo during long-term, relapse-prevention therapy of rapid- and non-rapid-cycling bipolar II disorder.

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Copyright
Corresponding author
Jay D. Amsterdam, MD, Depression Research Unit, University Science Center-3rd Floor, 3535 Market Street, Philadelphia, PA 19104, USA. Email: jamsterd@mail.med.upenn.edu
Footnotes
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See editorial, pp. 251-252, this issue.

Declarations of interest

None.

Footnotes
References
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Efficacy and mood conversion rate during long-term fluoxetine v. lithium monotherapy in rapid- and non-rapid-cycling bipolar II disorder

  • Jay D. Amsterdam (a1), Lola Luo (a2) and Justine Shults (a2)
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