Altshuler Lori L, Suppes Trisha, Black David O, Nolen Willem A, Leverich Gabriele, Keck Paul E, Frye Mark A, Kupka Ralph, McElroy Susan L, Grunze Heinz, Kitchen Christina M R, Post Robert
Dept. of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, 300 UCLA Medical Plaza, Suite 1544, Box 957057, Los Angeles, CA 90095-7057.
Am J Psychiatry. 2006 Feb;163(2):313-5. doi: 10.1176/appi.ajp.163.2.313.
The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder.
In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with bipolar II disorder, two with bipolar disorder not otherwise specified) were treated with one of three antidepressants as an adjunct to mood stabilizers. The patients' switch rates were assessed. Switch was defined as a Young Mania Rating Scale (YMRS) score >13 or a Clinical Global Impression (CGI) mania score > or =3 (mildly ill).
Depressed subjects with bipolar II disorder had a significantly lower acute switch rate into hypomania/mania when either YMRS or CGI criteria were used to define switch.
These data suggest that depressed patients with bipolar II disorder are less vulnerable than those with bipolar I disorder to switch into hypomania/mania when treated with an antidepressant adjunctive to a mood stabilizer.
作者比较了患有双相I型或双相II型障碍的抑郁症患者在接受第二代抗抑郁药治疗时转为轻躁狂/躁狂的发生率。
在一项为期10周的试验中，184例双相抑郁症门诊患者（134例双相I型障碍，48例双相II型障碍，2例未另行指定的双相障碍）接受三种抗抑郁药之一作为心境稳定剂的辅助治疗。评估患者的转换率。转换定义为杨氏躁狂评定量表（YMRS）评分>13或临床总体印象（CGI）躁狂评分>或=3（轻度疾病）。
当使用YMRS或CGI标准定义转换时，双相II型障碍的抑郁症患者转为轻躁狂/躁狂的急性转换率显著较低。
这些数据表明，在使用心境稳定剂辅助抗抑郁药治疗时，双相II型障碍的抑郁症患者比双相I型障碍的患者更不容易转为轻躁狂/躁狂。
