Literature DB >> 20361912

Why do clinicians maintain antidepressants in some patients with acute mania? Hints from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM), a large naturalistic study.

Adriane R Rosa1, Nùria Cruz, Carolina Franco, Josep Maria Haro, Jordan Bertsch, Catherine Reed, Trond F Aarre, Jose Sanchez-Moreno, Eduard Vieta.   

Abstract

OBJECTIVE: Antidepressants are supposed to be withdrawn during a manic episode. The aim of this study was to analyze the characteristics of manic patients who received antidepressants during a manic phase in a large, naturalistic study.
METHOD: The European Mania in Bipolar Longitudinal Evaluation of Medication was a 2-year prospective observational study of inpatients and outpatients with acute mania/mixed mania (DSM-IV or ICD-10 criteria) conducted in 14 European countries. Of 2,416 manic patients who continued into the maintenance phase of the study, 345 (14%) were taking an antidepressant and 2,071 (86%) were not taking an antidepressant at baseline, week 1, and/or week 2 postbaseline. Demographic and clinical variables were collected at baseline and each study visit up to 24 months. Outcome measures included the Clinical Global Impressions-Bipolar Disorder scale (CGI-BP overall, mania, and depression scores) at 12 weeks and 24 months, the 5-item Hamilton Depression Rating Scale (HDRS-5), and the Young Mania Rating Scale (YMRS) at 12 weeks only. The present study was conducted from December 2002 to June 2004.
RESULTS: More antidepressant maintenance use was seen in patients with mixed episodes (P < .001), rapid cyclers (P < .02), patients with more previous depressive episodes (P < .001), and patients with higher mean HDRS-5 score at baseline (P < .001)-specifically patients with anxiety (P = .013). Patients in the antidepressant group had significantly higher CGI-BP depression scores (P < .001) and a significantly higher rate of depression relapse (P < .001) at both 12 weeks and 24 months.
CONCLUSIONS: Patients with mania receiving antidepressants are more likely to be outpatients with mixed episodes, anxiety, or rapid cycling and have a higher risk of depression relapse during follow-up. Copyright 2010 Physicians Postgraduate Press, Inc.

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Year:  2010        PMID: 20361912     DOI: 10.4088/JCP.09m05026gre

Source DB:  PubMed          Journal:  J Clin Psychiatry        ISSN: 0160-6689            Impact factor:   4.384


  9 in total

1.  Socio-demographic and clinical characterization of patients with Bipolar Disorder I vs II: a Nationwide Italian Study.

Authors:  A Carlo Altamura; Massimiliano Buoli; Bruno Cesana; Bernardo Dell'Osso; Gianluigi Tacchini; Umberto Albert; Andrea Fagiolini; Andrea de Bartolomeis; Giuseppe Maina; Emilio Sacchetti
Journal:  Eur Arch Psychiatry Clin Neurosci       Date:  2017-04-01       Impact factor: 5.270

2.  Class effect of pharmacotherapy in bipolar disorder: fact or misbelief?

Authors:  Konstantinos N Fountoulakis; Xenia Gonda; Eduard Vieta; Zoltan Rihmer
Journal:  Ann Gen Psychiatry       Date:  2011-03-24       Impact factor: 3.455

3.  The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders.

Authors:  Isabella Pacchiarotti; David J Bond; Ross J Baldessarini; Willem A Nolen; Heinz Grunze; Rasmus W Licht; Robert M Post; Michael Berk; Guy M Goodwin; Gary S Sachs; Leonardo Tondo; Robert L Findling; Eric A Youngstrom; Mauricio Tohen; Juan Undurraga; Ana González-Pinto; Joseph F Goldberg; Ayşegül Yildiz; Lori L Altshuler; Joseph R Calabrese; Philip B Mitchell; Michael E Thase; Athanasios Koukopoulos; Francesc Colom; Mark A Frye; Gin S Malhi; Konstantinos N Fountoulakis; Gustavo Vázquez; Roy H Perlis; Terence A Ketter; Frederick Cassidy; Hagop Akiskal; Jean-Michel Azorin; Marc Valentí; Diego Hidalgo Mazzei; Beny Lafer; Tadafumi Kato; Lorenzo Mazzarini; Anabel Martínez-Aran; Gordon Parker; Daniel Souery; Ayşegül Ozerdem; Susan L McElroy; Paolo Girardi; Michael Bauer; Lakshmi N Yatham; Carlos A Zarate; Andrew A Nierenberg; Boris Birmaher; Shigenobu Kanba; Rif S El-Mallakh; Alessandro Serretti; Zoltan Rihmer; Allan H Young; Georgios D Kotzalidis; Glenda M MacQueen; Charles L Bowden; S Nassir Ghaemi; Carlos Lopez-Jaramillo; Janusz Rybakowski; Kyooseob Ha; Giulio Perugi; Siegfried Kasper; Jay D Amsterdam; Robert M Hirschfeld; Flávio Kapczinski; Eduard Vieta
Journal:  Am J Psychiatry       Date:  2013-11       Impact factor: 18.112

4.  Prevalence of suicide attempts in bipolar disorder: a systematic review and meta-analysis of observational studies.

Authors:  Min Dong; Li Lu; Ling Zhang; Qinge Zhang; Gabor S Ungvari; Chee H Ng; Zhen Yuan; Yifan Xiang; Gang Wang; Yu-Tao Xiang
Journal:  Epidemiol Psychiatr Sci       Date:  2019-10-25       Impact factor: 6.892

5.  Mixed states vs. pure mania in the French sample of the EMBLEM study: results at baseline and 24 months--European mania in bipolar longitudinal evaluation of medication.

Authors:  Jean-Michel Azorin; Elodie Aubrun; Jordan Bertsch; Catherine Reed; Stephanie Gerard; Michael Lukasiewicz
Journal:  BMC Psychiatry       Date:  2009-06-07       Impact factor: 3.630

6.  P2RX7: expression responds to sleep deprivation and associates with rapid cycling in bipolar disorder type 1.

Authors:  Lena Backlund; Catharina Lavebratt; Louise Frisén; Pernilla Nikamo; Dzana Hukic Sudic; Lil Träskman-Bendz; Mikael Landén; Gunnar Edman; Marquis P Vawter; Urban Ösby; Martin Schalling
Journal:  PLoS One       Date:  2012-08-28       Impact factor: 3.240

7.  How assess drugs in the treatment of acute bipolar mania?

Authors:  Michel Bourin; Florence Thibaut
Journal:  Front Pharmacol       Date:  2013-01-29       Impact factor: 5.810

8.  Pharmacotherapy for bipolar disorder and concordance with treatment guidelines: survey of a general population sample referred to a tertiary care service.

Authors:  Sabrina Paterniti; Jean-Claude Bisserbe
Journal:  BMC Psychiatry       Date:  2013-08-13       Impact factor: 3.630

9.  Hospital stay in patients admitted for acute bipolar manic episodes prescribed quetiapine immediate or extended release: a retrospective non-interventional cohort study (HOME).

Authors:  Oğuz Karamustafalıoğlu; Andreas Reif; Murad Atmaca; Domingo Gonzalez; Miriam Moreno-Manzanaro; Miguel Angel Gonzalez; Esteban Medina; Antonello Bellomo
Journal:  BMC Psychiatry       Date:  2014-08-31       Impact factor: 3.630

  9 in total

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