The Use of Short Half-Life Antidepressants in the Treatment of Bipolar Depression/Drs. Frye and Helleman Reply/Dr. Goldberg Replies

摘要

Dr. Liebowitz comments on the safety (i.e., reduced switch rate) and effectiveness of morning singledose immediate-release antidepressant therapy when there is a classic diurnal variation to the bipolar depressive episode. [...] patients with bipolar I disorder have responded more frequently to sleep deprivation than patients with major depression (3). The STEP-BD study did not evaluate depression outcomes with highly noradrenergic antidepressants, such as venlafaxine, but their apparent higher risk for induction of mania relative to predominantly serotonergic or dopaminergic antidepressants (4) would seem to prompt caution if one chose to expose a bipolar patient to other noradrenergic agents, especially those not studied in bipolar disorder, such as atomoxetine.