Authors: Henry, et al.
Title: Antidepressant-induced mania in bipolar patients: identification of risk factors
Reference: J Clin Psychiatry 2001;62:249-55.
Purpose: To identify risk factors associated with antidepressant-induced affective switch.
Study design: Prospective, naturalistic, longitudinal study.
Follow up: 6-week minimum.
Patients: 44 inpatients with bipolar depression.
Treatment: Various combinations of antidepressant with or without a mood stabilizer.
Results: The overall switch rate was 27%, with all switches occurring shortly after the start of antidepressant treatment. Switch rates for individual SSRIs were: fluvoxamine 33%, fluoxetine 25%, and paroxetine 20%. Lithium, but not valproate and carbamazepine, reduced switch rates (>40% without lithium versus 10% with concomitant lithium).