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Antidepressant Treatment for Acute Bipolar Depression An Update英文文献资料
HindawiPublishingCorporation
DepressionResearchandTreatment
Volume2012,ArticleID684725,10pages
doi:10.1155/2012/684725
ReviewArticle
AntidepressantTreatmentforAcuteBipolarDepression:
AnUpdate
BenH.Amit1,2andAbrahamWeizman 1,2
1
2
GehaMentalHealthCenter,ResearchUnit,P.O.Box102,PetachTikva49100,Israel
SacklerFacultyofMedicine,TelAvivUniversity,P.O.Box39040,TelAviv69978,Israel
CorrespondenceshouldbeaddressedtoBenH.Amit,dr.ben.amit@
Received23October2011;Accepted29November2011
AcademicEditor:Po-SeeChen
Copyright?2012B.H.AmitandA.Weizman.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution
License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly
cited.
Whilestudiesinthepasthavefocusedmoreontreatmentofthemanicphaseofbipolardisorder(BD),recent?ndingsdemonstrate
thedepressivephasetobeatleastasdebilitating.However,incontrasttounipolardepression,depressioninbipolarpatients
exhibitsavaryingresponsetoantidepressants,raisingquestionsregardingtheire?cacyandtolerability.Methods.Weconducteda
MEDLINEandCochraneCollaborationLibrarysearchforpaperspublishedbetween2005and2011onthesubjectofantidepres-
santtreatmentofbipolardepression.Sixty-eightarticleswereincludedinthepresentreview.Results.Whileafewstudiesdidadvo-
catetheuseofantidepressants,mostwell-controlledstudiesfailedtoshowarobuste?ectofantidepressantsinbipolardepression,
regardlessofantidepressantclassorbipolarsubtype.Therewasnosigni?cantincreaseintherateofmanic/hypomanicswitch,
especiallywithconcurrentuseofmoodstabilizers.Prescribingguidelinespublishedinrecentyearsrelymoreonatypicalanti-
psychotics,especiallyquetiapine,asa?rst-linetherapy.Conclusions.Antidepressantsprobablyhavenosubstantialroleinacutebi-
polardepression.However,inlightofcon?ictingresultsbetweenstudies,morewell-designedtrialsarewarranted.
1.Introduction
bothtocausefunctionalimpairment[9]andincreasetherisk
ofrelapse[10],emphasizingtheimportanceofoptimizing
thetreatmentforthedepressivephaseofB
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