Efficacy and mood conversion rate during long-term fluoxetine v. lithium
monotherapy in rapid- and non-rapid-cycling bipolar II disorder.
Author(s): Amsterdam JD(1), Luo L, Shults J.
Affiliation(s): Author information:
(1)Depression Research Unit, University of Pennsylvania School of Medicine,
Philadelphia, PA, USA. jamsterd@mail.med.upenn.edu
Publication date & source: 2013, Br J Psychiatry. , 202(4):301-6
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 NCT00044616).
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.
|