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IDIBAPS – Hospital Clínic investigators lead an international consensus about the use of antidepressants in bipolar disorder

The International Society for Bipolar Disorders (ISBD) recently presented an international consensus on the use of antidepressants in bipolar disorder. The article, published by The American Journal of Psychiatry, the most read general psychiatry journal and with a higher impact factor, has Dr. Isabella Pacchiarotti as its first author and Dr. Eduard Vieta as the last one, both from the IDIBAPS - Hospital Clínic Bipolar Disorders group. Shortly after its publication, the article was selected by the American Psychiatric Association among the 3 most important works of the year. Dr. Eduard Vieta will present it at the annual meeting of this Association, a conference with over 20,000 participants to be held in May 2014 in New York.

Although there is insufficient evidence for treatment benefits with antidepressants combined with mood stabilizers, a consensus was reached on 12 statements on the use of antidepressants in bipolar disorder. The task force acknowledged that individual bipolar patients may benefit from antidepressants. Regarding safety, serotonin reuptake inhibitors and bupropion may have lower rates of manic switch than tricyclic and tetracyclic antidepressants and norepinephrine-serotonin reuptake inhibitors. The frequency and severity of antidepressant-associated mood elevations appear to be greater in bipolar I than bipolar II disorder. Hence, in bipolar I patients antidepressants should be prescribed only as an adjunct to moodstabilizing medications.

Reference: Pacchiarotti I, Bond DJ, Baldessarini RJ, Nolen WA, Grunze H, Licht RW, Post RM, Berk M, Goodwin GM, Sachs GS, Tondo L, Findling RL, Youngstrom EA, Tohen M, Undurraga J, González-Pinto A, Goldberg JF, Yildiz A, Altshuler LL, Calabrese JR, Mitchell PB, Thase ME, Koukopoulos A, Colom F, Frye MA, Malhi GS, Fountoulakis KN, Vázquez G, Perlis RH, Ketter TA, Cassidy F, Akiskal H, Azorin JM, Valentí M, Mazzei DH, Lafer B, Kato T, Mazzarini L, Martínez-Aran A, Parker G, Souery D, Ozerdem A, McElroy SL, Girardi P, Bauer M, Yatham LN, Zarate CA, Nierenberg AA, Birmaher B, Kanba S, El-Mallakh RS, Serretti A, Rihmer Z, Young AH, Kotzalidis GD, Macqueen GM, Bowden CL, Ghaemi SN, Lopez-Jaramillo C, Rybakowski J, Ha K, Perugi G, Kasper S, Amsterdam JD, Hirschfeld RM, Kapczinski F, Vieta E.The International Society for Bipolar Disorders (ISBD) Task Force Report on Antidepressant Use in Bipolar Disorders. Am J Psychiatry. 2013 Nov 1;170(11):1249-62. doi: 10.1176/appi.ajp.2013.13020185. Read the abstract