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Effectiveness and safety of long-term antidepressant treatment in bipolar disorder
S N Ghaemi1, M S Lenox, R J Baldessarini
1Consolidated Department of Psychiatry, Harvard Medical School, Boston, Mass, USA. nassir_ghaemi@hms.harvard.edu
Objective:
We sought to review research on use of antidepressants for long-term treatment of bipolar depression.
Method:
We conducted a computerized literature search of the MEDLINE, HealthStar, Current Contents, PsychInfo, and National Library of Medicine databases to identify studies involving antidepressant, anticonvulsant, or lithium use in bipolar disorder or manic-depressive illness published from 1966 through 2000.
Results:
Only 7 blinded, controlled trials of long-term antidepressant treatment in bipolar disorders were found. The available information is not adequate to support the safety or effectiveness of long-term antidepressant treatment for bipolar depression, with or without mood-stabilizing cotherapy.
Conclusion:
Antidepressant treatment of bipolar depression is extraordinarily understudied. Controlled trials comparing specific antidepressants, particularly to compare mood-stabilizing agents given alone and combined with an antidepressant, are needed.
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