Posted by jrbecker on July 1, 2003, at 14:41:09
http://biz.yahoo.com/rc/030701/health_bipolordisorder_antidepressants_1.html
http://ajp.psychiatryonline.org/cgi/content/full/160/7/1252
Reuters
Antidepressant regimen aids bipolar disorder-study
Tuesday July 1, 12:02 am ET
By Deena BeasleyLOS ANGELES, July 1 (Reuters) - Patients with bipolar disorder should continue taking antidepressants even after their symptoms have eased, researchers suggested on Tuesday in a break with standard practice.
Usual guidelines for treating the chronic disorder, also known as manic depression, recommend discontinuing antidepressants within six months of improvement.But researchers from the University of California at Los Angeles found that patients treated under those guidelines were nearly twice as likely to relapse as those who continued taking antidepressants along with mood stabilizing medication for the first year after remission of acute bipolar depression.
They also found no increased risk of manic relapse in study participants who continued the medication for a year.
Manic depression, marked by swings from euphoria to despair, is one of the most common mental illnesses, with some research suggesting it affects nearly eight million American adults.
"Psychiatrists are taught that when someone is depressed you put them an antidepressants, but when the patient is bipolar there was always a risk of inducing mania," said Mark Frye, director of UCLA's Bipolar Disorder Research Program and a co-author of the study. "Maybe we need to be thinking of antidepressants as long-term therapy for bipolar patients who were depressed and did well on medication."
The study findings appear in the July 2003 issue of the American Journal of Psychiatry.
The work was supported by the Stanley Medical Research Institute, a nonprofit organization that supports research on the causes and treatment of schizophrenia and bipolar disorder. Three pharmaceutical companies provided free medication -- including drugs such as Glaxo's Wellbutrin and Pfizer Inc.'s (NYSE:PFE - News) Zoloft -- but no other financial support.
"The common clinical practice of discontinuing antidepressant use in bipolar patients soon after remission of depression symptoms may actually increase the risk of relapse," Dr. Lori Altshuler, a professor at the UCLA Neuropsychiatric Institute and the study's lead author, said in a statement.
The U.S. Food and Drug Administration (News - Websites) last week approved Lamictal, GlaxoSmithKline Plc's (London:GSK.L - News) anti-seizure pill, as the first new maintenance therapy for bipolar disorder since the introduction of lithium in the 1970s.
The UCLA study examined 84 individuals with bipolar disorder whose depression symptoms eased with the addition of an antidepressant to an ongoing mood stabilizer, such as lithium or Eli Lilly & Co.'s (NYSE:LLY - News) Zyprexa.
At one year after improvement of depression symptoms, 70 percent of the antidepressant discontinuation group had relapsed, compared to 36 percent of the continuation group.
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