An Update on Antidepressant Use in Bipolar Depression

作者：Sidor Michelle M; MacQueen Glenda M^*

来源：Current Psychiatry Reports, 2012, 14(6): 696-704.

DOI：10.1007/s11920-012-0323-6

• Bipolar disorder
• Major depression
• Bipolar depression
• Antidepressant
• Response
• Remission
• Switch
• Treatment outcome
• Prescribing guidelines
• Pharmacotherapy
• Psychiatry

The effective treatment of depression in people with bipolar disorder remains a clinical challenge. The role of antidepressant medication in treating bipolar depression has been controversial. While early studies and meta-analyses supported a role for antidepressant medication, more recent, high quality randomized controlled trials in bipolar depression have generally not demonstrated efficacy for antidepressant medications. Although the risk of affective switch and long-term de-stabilization remains a concern when using antidepressant medications in bipolar disorder, the magnitude of this risk has been difficult to ascertain with confidence. Maintenance use of antidepressant medication has generally not demonstrated a favorable risk-benefit ratio. Future studies should explore the patient characteristics and response patterns that predict a more favorable response profile to antidepressants amongst patients with bipolar disorder so that the medications can be rationally used in those who are most likely to benefit.

• 出版日期2012-12