Differential prevalence and demographic and clinical correlates of antidepressant use in American bipolar I versus bipolar II disorder patients

Farnaz Hooshmand, Dennis Do, Saloni Shah, Anda Gershon, Dong Yeon Park, Hyun Kim, Laura D. Yuen, Bernardo Dell'Osso, Po W. Wang, Terence A. Ketter, Shefali Miller

Research output: Contribution to journalArticle

Abstract

Aims: Antidepressant use is controversial in bipolar disorder (BD) due to questionable efficacy/psychiatric tolerability. We assessed demographic/clinical characteristics of baseline antidepressant use in BD patients. Methods: Prevalence and correlates of baseline antidepressant use in 503 BD I and BD II outpatients referred to the Stanford Bipolar Clinic during 2000–2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Results: Antidepressant use was 39.0%, overall, and was higher in BD II versus BD I (46.9% versus 30.5%, p = 0.0002). Both BD I and BD II antidepressant compared to non-antidepressant users had higher rates of complex pharmacotherapy (≥ 4 mood stabilizers, antipsychotics, and/or antidepressants) and use of other psychotropics. Antidepressant use in BD II versus BD I was higher during euthymia (44.0% vs. 28.0%) and subsyndromal symptoms (56.1% vs. 28.6%), but not depression or mood elevation. Limitations: American tertiary BD clinic referral sample receiving open naturalistic treatment. Conclusions: In our sample, antidepressant use was higher in BD II versus BD I patients, and was associated with markers of heightened illness severity in both BD I and BD II patients. Additional research is warranted to investigate these complex relationships.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalJournal of Affective Disorders
Volume234
DOIs
Publication statusPublished - Jul 1 2018

Keywords

  • Antidepressant
  • Bipolar disorder
  • Illness characteristics

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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