Efficacy and safety of antidepressant monotherapy in the treatment of bipolar-II depression

New York State Psychiatric Institute and Columbia College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
International Clinical Psychopharmacology (Impact Factor: 3.1). 10/2007; 22(5):309-11. DOI: 10.1097/YIC.0b013e3280c28410
Source: PubMed

ABSTRACT Sparse data exist regarding the risks and benefits of treating bipolar-II depression with antidepressants alone. On the basis of studies of bipolar-I patients, treatment guidelines suggest antidepressants should be augmented with mood stabilizers. Whether these recommendations apply to bipolar-II is unclear. A post-hoc analysis of a double-blind study, which compared the relative efficacy of placebo, imipramine and phenelzine in depressed outpatients. Patients rated 1 ('very much improved') or 2 ('much improved') on the Clinical Global Inventory Scale were considered responders. In an intent to treat analysis, no significant differences between bipolar patients (N=62) and unipolar patients (N=248) in response rates to placebo, imipramine and phenelzine were seen. No patient developed manic symptoms that required medication discontinuation or mood stabilizer augmentation. Antidepressant monotherapy was found to be a safe and effective treatment for bipolar-II depression.

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