Abstract | OBJECTIVE: METHOD: An expert task force iteratively developed consensus through serial consensus-based revisions using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new or reworded items and items that needed to be rerated. This process resulted in the final ISBD Task Force clinical recommendations on antidepressant use in bipolar disorder. RESULTS: There is striking incongruity between the wide use of and the weak evidence base for the efficacy and safety of antidepressant drugs in bipolar disorder. Few well-designed, long-term trials of prophylactic benefits have been conducted, and there is insufficient evidence for treatment benefits with antidepressants combined with mood stabilizers. A major concern is the risk for mood switch to hypomania, mania, and mixed states. Integrating the evidence and the experience of the task force members, a consensus was reached on 12 statements on the use of antidepressants in bipolar disorder. CONCLUSIONS:
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Authors | Isabella Pacchiarotti, David J Bond, Ross J Baldessarini, Willem A Nolen, Heinz Grunze, Rasmus W Licht, Robert M Post, Michael Berk, Guy M Goodwin, Gary S Sachs, Leonardo Tondo, Robert L Findling, Eric A Youngstrom, Mauricio Tohen, Juan Undurraga, Ana González-Pinto, Joseph F Goldberg, Ayşegül Yildiz, Lori L Altshuler, Joseph R Calabrese, Philip B Mitchell, Michael E Thase, Athanasios Koukopoulos, Francesc Colom, Mark A Frye, Gin S Malhi, Konstantinos N Fountoulakis, Gustavo Vázquez, Roy H Perlis, Terence A Ketter, Frederick Cassidy, Hagop Akiskal, Jean-Michel Azorin, Marc Valentí, Diego Hidalgo Mazzei, Beny Lafer, Tadafumi Kato, Lorenzo Mazzarini, Anabel Martínez-Aran, Gordon Parker, Daniel Souery, Ayşegül Ozerdem, Susan L McElroy, Paolo Girardi, Michael Bauer, Lakshmi N Yatham, Carlos A Zarate, Andrew A Nierenberg, Boris Birmaher, Shigenobu Kanba, Rif S El-Mallakh, Alessandro Serretti, Zoltan Rihmer, Allan H Young, Georgios D Kotzalidis, Glenda M MacQueen, Charles L Bowden, S Nassir Ghaemi, Carlos Lopez-Jaramillo, Janusz Rybakowski, Kyooseob Ha, Giulio Perugi, Siegfried Kasper, Jay D Amsterdam, Robert M Hirschfeld, Flávio Kapczinski, Eduard Vieta |
Journal | The American journal of psychiatry
(Am J Psychiatry)
Vol. 170
Issue 11
Pg. 1249-62
(Nov 2013)
ISSN: 1535-7228 [Electronic] United States |
PMID | 24030475
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Advisory Committees
- Affect
(drug effects)
- Antidepressive Agents
(adverse effects, therapeutic use)
- Bipolar Disorder
(drug therapy)
- Consensus
- Delphi Technique
- Humans
- Suicide
(psychology)
- Treatment Outcome
- Suicide Prevention
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