期刊
CURRENT PSYCHIATRY REPORTS
卷 12, 期 6, 页码 512-521出版社
SPRINGER
DOI: 10.1007/s11920-010-0157-z
关键词
Bipolar disorder; Neurochemistry; Antidepressant; Treatment-emergent mania; Mechanism
类别
资金
- World Psychiatric Association
- Shanghai Jiao-Tong University School of Medicine Natural Science Foundation [09XJ21024]
- Chinese National Key Technologies Research and Development Program [2004BA720A21-02]
- Chinese National High-Tech Research and Development Program [2006AA02Z430]
- Climbing Mountain Action Plan Program [064119533]
- National Institutes of Health
- Department of Defense, Health Resources Services Administration
- National Institute of Mental Health
- NARSAD
- Cleveland Foundation
- Abbott Laboratories
- AstraZeneca
- Bristol-Myers Squibb
- Cephalon
- Eli Lilly and Company
- GlaxoSmithKline
- Janssen Pharmaceutica
- Repligen Corp.
- Stanley Medical Research Institute
- Takeda Pharmaceuticals North America
- Wyeth
Current data suggest that monoamines, acetylcholine, amino acids, cortisol, thyroid hormones, and melatonin may be involved in the pathophysiology of bipolar disorder (BPD). Any neuropsychological or pharmacologic factor causing a disturbance in these neurochemicals may trigger manic/hypomanic switching. Antidepressants, stimulants, anticholinergics, steroids, and thyroid hormone have been reported to cause treatment-emergent mania (TEM) in BPD, but only recently have the traditional antidepressants been systematically studied. Paroxetine, 20 mg/d, monotherapy in treatment of acute, relatively pure bipolar I and II depression, and fluoxetine monotherapy in bipolar II depression conferred a similar risk as placebo for TEM. Paroxetine or bupropion adjunctive therapy to mood stabilizer(s) had a similar risk as placebo for treatment of TEM in real world patients with bipolar depression during continuation treatment. Venlafaxine was shown to have an increased risk of TEM compared with bupropion and sertraline. The evolving literature continues to support the role of mood stabilizers in preventing future mood episodes of BPD.
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