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Do antidepressants influence mood patterns? A naturalistic study in bipolar disorder

Published online by Cambridge University Press:  16 April 2020

M. Bauer ,
N. Rasgon ,
P. Grof ,
T. Glenn ,
M. Lapp ,
W. Marsh ,
R. Munoz ,
A. Suwalska ,
C. Baethge  and
T. Bschor
...Show all authors
M. Bauer*
Affiliation:
Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlin, Germany Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
N. Rasgon
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA Department of Psychiatry, Stanford School of Medicine, Palo Alto, CA, USA
P. Grof
Affiliation:
Mood Disorders Clinic of Ottawa, Ottawa, Canada
T. Glenn
Affiliation:
ChronoRecord Association, Inc. (www.chronorecord.org), Fullerton, CA, USA
M. Lapp
Affiliation:
Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlin, Germany
W. Marsh
Affiliation:
Department of Psychiatry, Stanford School of Medicine, Palo Alto, CA, USA
R. Munoz
Affiliation:
Department of Psychiatry, University of California San Diego, San Diego, CA, USA
A. Suwalska
Affiliation:
Department of Psychiatry, Karol Marcinkowski University of Medical Science, Poznan, Poland
C. Baethge
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
T. Bschor
Affiliation:
Department of Psychiatry and Psychotherapy, Jewish Hospital of Berlin, Berlin, Germany
M. Alda
Affiliation:
Department of Psychiatry, McGill University, Montreal, Quebec, Canada
P.C. Whybrow
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
*
*Corresponding author. E-mail address: michael.bauer@charite.de (M. Bauer).
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Abstract

This prospective, longitudinal study compared the frequency and pattern of mood changes between outpatients receiving usual care for bipolar disorder who were either taking or not taking antidepressants. One hundred and eighty-two patients with bipolar disorder self-reported mood and psychiatric medications for 4 months using a computerized system (ChronoRecord) and returned 22,626 days of data. One hundred and four patients took antidepressants, 78 did not. Of the antidepressants taken, 95% were selective serotonin or norepinephrine reuptake inhibitors, or second-generation antidepressants. Of the patients taking an antidepressant, 91.3% were concurrently taking a mood stabilizer. The use of antidepressants did not influence the daily rate of switching from depression to mania or the rate of rapid cycling, independent of diagnosis of bipolar I or II. The primary difference in mood pattern was the time spent normal or depressed. Patients taking antidepressants frequently remained in a subsyndromal depression. In this naturalistic study using self-reported data, patients with bipolar disorder who were taking antidepressants—overwhelmingly not tricyclics and with a concurrent mood stabilizer—did not experience an increase in the rate of switches to mania or rapid cycling compared to those not taking antidepressants. Antidepressants had little impact on the mood patterns of bipolar patients taking mood stabilizers.

Keywords

Bipolar disorderAntidepressantsManiaRapid cyclingSwitchMood stabilizer
Type
Original articles
Information
European Psychiatry , Volume 21 , Issue 4 , June 2006 , pp. 262 - 269
Copyright
Copyright © European Psychiatric Association 2006

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