Rapid cyclers, temperament, and antidepressants

Kukopulos, A.; Caliari, B.; Tundo, Antonio; Minnai, Gian Paolo; Floris, Gianfranco; Reginaldi, Daniela; Tondo, Leonardo

doi:10.1016/0010-440x(83)90076-7

Cited by 142 publications

(79 citation statements)

References 13 publications

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“…These findings are in agreement with a study by Kukopulos et al, 13 who observed an increased number of episodes after antidepressant use. Altshuler et al observed that 46% of the patients with antidepressant-associated mania presented cycle acceleration.…”

Section: Discussionsupporting

confidence: 83%

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Antidepressant treatment-emergent affective switch in bipolar disorder: a prospective case-control study of outcome

Tamada¹,

Amaral²,

Issler³

et al. 2006

Rev. Bras. Psiquiatr.

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Antidepressant treatment-emergent affective switch in bipolar disorder: a prospective case-control study of outcome Ciclagem afetiva associada a tratamento com antidepressivo no transtorno bipolar: estudo caso-controle prospectivo A b s t r a c t Objective: Treatment-emergent affective switch has been associated to cycle acceleration and poorer outcome, but there are few studies addressing this issue. The aim of this study was to prospectively compare the outcome of patients presenting treatment-emergent affective switch with patients with spontaneous mania, regarding presence and polarity of a new episode and time to relapse. Method: Twenty-four patients with bipolar disorder according to the DSM-IV were followed for 12 months. Twelve patients had treatment-emergent affective switch and twelve had spontaneous mania. Patients were evaluated weekly with the Young Mania Rating Scale and the Hamilton Depression Scale until remission of the index episode, and monthly until completion of the 12-month follow-up. Results: Eleven patients with treatment-emergent affective switch had a recurrence on follow-up, all of them with major depressive episodes. In the group with spontaneous mania, six patients had a recurrence: two had a depressive episode, and four had a manic episode (p = 0.069 for new episode, p = 0.006 for polarity of the episode). Patients with treatment-emergent affective switch relapsed in a shorter period than patients with spontaneous mania (p = 0.016). Conclusions: In this first prospective study, treatment-emergent affective switch patients were at greater risk of relapses, especially depressive episodes, and presented a shorter duration of remission when compared with patients with spontaneous mania. Descriptors: Bipolar disorder; Clinical protocol; Antidepressive agents; Treatment outcome; Affective symptomsResumo Objetivo: A ciclagem para mania associada ao antidepressivo tem sido relacionada à aceleração do ciclo e pior evolução, mas há poucos estudos na literatura sobre este assunto. O objetivo deste estudo foi comparar prospectivamente a evolução de pacientes com mania associada a antidepressivo com pacientes com mania espontânea, em relação a tempo para recaída e polaridade do novo episódio. Método: Vinte e quatro pacientes com transtorno bipolar, de acordo com os critérios diagnósticos do DSM-IV, foram seguidos por 12 meses: 12 pacientes com mania associada a antidepressivo e 12 pacientes com mania espontânea. Os pacientes foram avaliados semanalmente com a Escala para Mania de Young e a Escala para Depressão de Hamilton até remissão do episódio inicial e, mensalmente, até completar o período de seguimento de 12 meses. Resultados: Onze pacientes com mania associada ao antidepressivo tiveram uma recorrência no seguimento, sendo todos os episódios depressivos. No grupo de mania espontânea, seis pacientes apresentaram recorrência, sendo dois episódios depressivos, e quatro episódios de mania (p = 0,069 para novo episódio e p = 0,006 para polaridade do episódio). Pacientes com mania associada a an...

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Section: Discussionsupporting

confidence: 83%

“…13 Pickar et al suggested that antidepressants could modify the course of the disorder by sensitization, that is, the exposure to an antidepressant would make the patient more sensitive to the next exposure to an antidepressant.…”

Section: -12mentioning

confidence: 99%

Antidepressant treatment-emergent affective switch in bipolar disorder: a prospective case-control study of outcome

Tamada¹,

Amaral²,

Issler³

et al. 2006

Rev. Bras. Psiquiatr.

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“…Particularly associated to the use of antidepressants is the rapid cycling course (Kukopulos et al, 1983). The stabilization of rapid cyclers is often very difficult.…”

Section: Treatment-resistant Bipolar Disordersmentioning

confidence: 99%

Memantine: A New Mood Stabilizer for Treatment-Resistant Bipolar Disorders

Serra¹,

Serra²,

Koukopoulos³

et al. 2012

Bipolar Disorder - A Portrait of a Complex Mood Disorder

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“…14 In fact, reports of efficacy in the management of treatment-resistant and bipolar depression, along with low rates of induction of mania, have led to increased use of these agents at some centers. 3,[15][16][17][18] When they are prescribed, MAOIs are often given at inadequate doses. 7,19-22 Like most other antidepressants, the dose should be titrated upward for therapeutic response.…”

mentioning

confidence: 99%

The Role of Monoamine Oxidase Inhibitors in Current Psychiatric Practice

Fiedorowicz

Swartz

2004

Journal of Psychiatric Practice

136

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The use of monoamine oxidase inhibitors (MAOIs) by psychiatrists has declined over the past several decades with the expansion of psychiatrists' pharmacologic armamentarium. This trend has also been driven by concern about food and drug interactions and side effects, as well as waning physician experience with these medications. Many psychiatrists, in fact, never prescribe MAOIs. Recent research has liberalized the MAOI diet and identified symptom presentations more likely to respond to these medications. Thus, clinicians must continue to familiarize themselves with the properties of and indications for prescribing MAOIs. Keywords psychopharmacology; drug response; monoamine oxidase inhibitors (MAOIs); phenelzine; isocarboxazid; tranylcypromine; moclobemide; selegiline; dosage; physician prescribing practices; major depression; bipolar depression; atypical depression; treatment-refractory depression CURRENTLY AVAILABLE MONOAMINE OXIDASE INHIBITORSThe nonselective monoamine oxidase inhibitors (MAOIs) currently available in the United States include phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine (Parnate). These medications are irreversible inhibitors of the enzyme monoamine oxidase (MAO).Selegeline is a selective inhibitor of type B MAO (MAO B ) and is currently approved by the United States Food and Drug Administration for parkinsonism. Current studies using selegeline for depression are discussed at the end of this article in the section on "Future Directions."Moclobemide is a reversible inhibitor of type A MAO (MAO A ) and is consequently believed to require fewer dietary restrictions.

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Rapid cyclers, temperament, and antidepressants

Cited by 142 publications

References 13 publications

Antidepressant treatment-emergent affective switch in bipolar disorder: a prospective case-control study of outcome

Antidepressant treatment-emergent affective switch in bipolar disorder: a prospective case-control study of outcome

Memantine: A New Mood Stabilizer for Treatment-Resistant Bipolar Disorders

The Role of Monoamine Oxidase Inhibitors in Current Psychiatric Practice

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