Correction for The British Journal of Psychiatry 189 (6) 569.
The British Journal of Psychiatry (2006) 189: 124-131. doi: 10.1192/bjp.bp.105.013045
© 2006 The Royal College of Psychiatrists
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Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline

R. M. Post, MD

Department of Health and Human Services, National Institute of Mental Health, Bethesda, Maryland

L. L. Altshuler, MD

UCLA Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine and West Los Angeles VA Medical Center, Los Angeles, California

G. S. Leverich, MSW

Department of Health and Human Services, National Institute of Mental Health, Bethesda, Maryland

M. A. Frye, MD

UCLA Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine and West Los Angeles VA Medical Center, Los Angeles, California

W. A. Nolen, MD

University Hospital Groningen, Groningen, and Altrecht Institute of Mental Health Care, Utrecht

R. W. Kupka, MD, PhD

Altrecht Institute of Mental Health Care, Utrecht, The Netherlands

T. Suppes, MD

University of Texas, Southwestern Medical Center, Dallas, Texas

S. McElroy, MD and P. E. Keck, MD

Psychopharmacology Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio

K. D. Denicoff, MD

Department of Health and Human Services, National Institute of Mental Health, Bethesda, Maryland, USA

H. Grunze, MD

University of Munich, Munich

J. Walden, MD

University of Freiberg, Freiberg, Germany

C. M. R. Kitchen, PhD

Department of Biostatistics, School of Public Health, UCLA, Los Angeles, California

J. Mintz, PhD

UCLA Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine and West Los Angeles VA Medical Center, Los Angeles, California, USA

Correspondence: Dr Robert M. Post, Bldg 10, Room 3S239, 10 Center Drive MSC1272, Bethesda, Maryland 20892-1272, USA. Tel: +1 301 496 4805; fax: +1 301 402 0052; email: postr{at}mail.nih.gov

Declaration of interest None.

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 I, II 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.




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