Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour The Role of Underlying Bipolarity英文文献资料.docVIP

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Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour The Role of Underlying Bipolarity英文文献资料.doc

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Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour The Role of Underlying Bipolarity英文文献资料

HindawiPublishingCorporation DepressionResearchandTreatment Volume2011,ArticleID906462,5pages doi:10.1155/2011/906462 ReviewArticle Antidepressant-ResistantDepression andAntidepressant-AssociatedSuicidalBehaviour: TheRoleofUnderlyingBipolarity ZoltanRihmerandXeniaGonda DepartmentofClinicalandTheoreticalMentalHealth,K′utv¨olgyiClinicalCenter,SemmelweisUniversity,K′utv¨olgyiu′t4., 1125Budapest,Hungary CorrespondenceshouldbeaddressedtoXeniaGonda,kendermagos@ Received30September2010;Accepted8February2011 AcademicEditor:AlessandroSerretti Copyright?2011Z.RihmerandX.Gonda.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporarypsychiatry.Basedontheliterature,thispapersummarizestheauthor’sviewonantidepressant-resistantdepression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypo)manic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children and adolescents. As earlyageatonsetofmajordepressiveepisodeandmixeddepressionarepowerfulclinicalmarkersofbipolarityandthemanic componentofbipolardisorder (andpossibleits biologicalbackground) showsa decliningtendency with ageantidepressant- resistance/worsening,antidepressant-induced(hypo)manicswitchesand“suicide-inducing”potentialofantidepressantsseemto berelatedtotheunderlyingbipolarity. 1.Introduction response after at least two adequate trials of di?erent classes of antidepressants. In spite of the fact that there are several causes of AD-RD in general [1, 6], one of the most common sources of it is the unrecognized bipolar natureofthe“un