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Short-term venlafaxine v. lithium monotherapy for bipolar type II major depressive episodes: Effectiveness and mood conversion rate

  • Jay D. Amsterdam (a1), Lorenzo Lorenzo-Luaces (a2), Irene Soeller (a3), Susan Qing Li (a3), Jun J. Mao (a4) and Robert J. DeRubeis (a5)...
Abstract
Background

Controversy exists over antidepressant use in bipolar II depression.

Aims

To compare the safety and effectiveness of antidepressant v. mood stabiliser monotherapy for bipolar type II major depressive episodes.

Method

Randomised, double-blind, parallel-group, 12-week comparison of venlafaxine (n = 65) v. lithium (n = 64) monotherapy in adult out-patients (trial registration number NCT00602537).

Results

Primary outcome – venlafaxine produced a greater response rate (67.7%) v. lithium (34.4%, P<0.001). Secondary outcomes – venlafaxine produced a greater remission rate (58.5% v. 28.1%, P<0.001); greater decline in depression symptom scores over time (β=–5.32, s.e. = 1.16, χ2 = 21.19, P<0.001); greater reduction in global severity scores over time (β=–1.05, s.e. = 0.22, χ2 = 22.33, P<0.001); and greater improvement in global change scores (β=–1.31, s.e. = 0.32, χ2 = 16.95, P<0.001) relative to lithium. No statistically significant or clinically meaningful differences in hypomanic symptoms were observed between treatments.

Conclusions

These findings suggest that short-term venlafaxine monotherapy may provide effective antidepressant treatment for bipolar II depression without a statistically significant increase in hypomanic symptoms relative to lithium.

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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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This research was supported by NIMH grant MH060353. Additional support for the preparation of this manuscript was provided by NIH grant MH080097 and The Jack Warsaw Fund for Research in Biological Psychiatry of the University of Pennsylvania Medical Center.

Declaration of interest

None.

Footnotes
References
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Short-term venlafaxine v. lithium monotherapy for bipolar type II major depressive episodes: Effectiveness and mood conversion rate

  • Jay D. Amsterdam (a1), Lorenzo Lorenzo-Luaces (a2), Irene Soeller (a3), Susan Qing Li (a3), Jun J. Mao (a4) and Robert J. DeRubeis (a5)...
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