Original paper

European Archives of Psychiatry and Clinical Neuroscience

, Volume 248, Issue 6, pp 296-300

First online:

Antidepressant-associated maniform states in acute treatment of patients with bipolar-I depression

  • R. BottlenderAffiliated withPsychiatrische Klinik der Ludwig-Maximilians-Universität, Nussbaumstrasse 7, D-80336 Munich, Germany e-mail: bottlend@psy.med.uni-muenchen.de, Fax: +49-89-5160 4749
  • , Daniel RudolfAffiliated withPsychiatrische Klinik der Ludwig-Maximilians-Universität, Nussbaumstrasse 7, D-80336 Munich, Germany e-mail: bottlend@psy.med.uni-muenchen.de, Fax: +49-89-5160 4749
  • , Anton StraussAffiliated withPsychiatrische Klinik der Ludwig-Maximilians-Universität, Nussbaumstrasse 7, D-80336 Munich, Germany e-mail: bottlend@psy.med.uni-muenchen.de, Fax: +49-89-5160 4749
  • , Hans-Jürgen MöllerAffiliated withPsychiatrische Klinik der Ludwig-Maximilians-Universität, Nussbaumstrasse 7, D-80336 Munich, Germany e-mail: bottlend@psy.med.uni-muenchen.de, Fax: +49-89-5160 4749

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Abstract

Medical records of 158 patients with bipolar depression were analysed for the incidence of a switch from depression to maniform states (mania and hypomania). Relation to psychopharmacological treatment was investigated. Thirty-nine (25%) patients of the total sample had switched to a maniform state during the treatment period in the hospital. Among that group the phenomenon occurred in 23 patients (15%) as a hypomania and in 16 patients (10%) as a mania. Patients with a switch were significantly more often treated with tricyclic antidepressants (TCA) than patients without switch (79.5% vs 51.3%). Mood stabilising medication might reduce the risk for switching, especially in patients treated with TCA; however, it seems not totally sufficient, since 59% of the switched patients received mood stabilisers. The switch phenomenon was not associated with sociodemographic or clinical data.

Key words Bipolar-I depression Switch Antidepressants Mood stabiliser