Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline

R. M. Post*, L. L. Altshuler, G. S. Leverich, M. A. Frye, W. A. Nolen, R. W. Kupka, T. Suppes, S. McElroy, P. E. Keck, K. D. Denicoff, H. Grunze, C. M. R. Kitchen, J. Mintz

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

264 Citaten (Scopus)


Background: Few studies have examined the relative risks of switching into hypomania or mania associated with second-generation antidepressant drugs in bipolar depression.

Aims: To examine the relative acute effects of bupropion, sertraline and venlafaxine as adjuncts to mood stabilisers.

Method: In a 10-week trial, participants receiving out-patient treatment for bipolar disorder (stratified for rapid cycling) were randomly treated with a flexible dose of one of the antidepressants, or their respective matching placebos, as adjuncts to mood stabilisers.

Results: A total of 174 adults with bipolar disorder 1, 11 or not otherwise specified, currently in the depressed phase, were included. All three antidepressants were associated with a similar range of acute response (49-53%) and remission (34-41%). There was a significantly increased risk of switches into hypomania or mania in participants treated with venlafaxine compared with bupropion or sertraline.

Conclusions: More caution appears indicated in the use of venlafaxine rather than bupropion or sertraline in the adjunctive treatment of bipolar depression, especially if there is a prior history of rapid cycling.

Declaration of interest: None.

Originele taal-2English
Pagina's (van-tot)124-131
Aantal pagina's8
TijdschriftThe British Journal of Psychiatry
StatusPublished - aug-2006

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