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首页> 外文期刊>The journal of clinical psychiatry >Impact of antidepressant continuation after acute positive or partial treatment response for bipolar depression: a blinded, randomized study.
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Impact of antidepressant continuation after acute positive or partial treatment response for bipolar depression: a blinded, randomized study.

机译：双相抑郁症的急性阳性或部分治疗反应后抗抑郁药持续治疗的影响：一项随机，双盲研究。

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OBJECTIVE: To assess long-term outcome in bipolar disorder, subjects were prospectively followed after receiving acute treatment for bipolar depression. METHOD: Eighty-three outpatients with DSM-IV bipolar depression who were enrolled between March 1996 and November 2002 and were treated in a 10-week acute double-blind antidepressant treatment trial agreed to participate in a 1-year double-blind continuation of their medication. In the acute antidepressant treatment trial, subjects were treated with a mood stabilizer plus 1 of 3 randomly assigned antidepressants. Sixty-one subjects had attained an acute positive antidepressant response (50% improvement on the Inventory for Depressive Symptomatology [IDS] or 2-point improvement on the Clinical Global Impression for Bipolar Disorder [CGI-BP]) and 22 subjects achieved only acute partial improvement at the end of the 10-week acute trial. In the blinded continuation phase immediately following the acute trial, subjects continued on the same medications and were rated monthly for up to 1 year using the IDS, CGI-BP, and the Young Mania Rating scale. RESULTS: At study endpoint, 42 (69%) of the 61 acute positive responders maintained positive response and 32 (53%) achieved remission. Compared to the acute positive responders, 6 (27%) of the 22 acute partial responders had achieved positive treatment response at study endpoint (p < .001). Eight acute positive responders (13%) and 5 acute partial responders (22%) developed mania. CONCLUSION: Patients who achieve a positive acute antidepressant response to 10 weeks of antidepressant treatment adjunctive to a mood stabilizer will probably maintain response with the same continued treatment. Patients who achieve only a partial acute antidepressant response are less likely to further improve when the same treatment is sustained. The switch rate into mania for patients being treated with an antidepressant adjunctive to a mood stabilizer is not higher than the reported rate for patients on mood stabilizer monotherapy.
机译：目的：为了评估双相情感障碍的长期结果，对接受双相抑郁症的急性治疗的受试者进行前瞻性随访。方法：1996年3月至2002年11月之间入组并在10周急性双盲抗抑郁治疗试验中接受治疗的DSM-IV双相抑郁症的门诊患者共83例，他们同意接受其1年双盲持续治疗药物。在急性抗抑郁药治疗试验中，用稳定剂加随机分配的3种抗抑郁药中的1种治疗受试者。六十一名受试者获得了急性抗抑郁药阳性反应（抑郁症状清单[IDS]改善了50％，双相情感障碍临床总体印象[CGI-BP]改善了两分），而22名受试者仅实现了急性部分抗抑郁药10周急性试验结束时改善。在急性试验后的盲连续期中，受试者继续使用相同的药物，并使用IDS，CGI-BP和Young Mania Rating量表对患者进行长达1年的每月评估。结果：在研究终点，61位急性阳性反应者中有42位（69％）维持阳性反应，有32位（53％）获得缓解。与急性阳性反应者相比，22个急性部分反应者中有6个（27％）在研究终点达到阳性治疗反应（p <.001）。八名急性阳性反应者（13％）和五名急性部分反应者（22％）发展为躁狂。结论：对伴有情绪稳定剂的10周抗抑郁药治疗取得了急性抗抑郁药阳性反应的患者，可能会在继续进行相同治疗的情况下保持应答。如果持续进行相同的治疗，仅达到部分急性抗抑郁反应的患者则不太可能进一步改善。对于接受了情绪稳定剂辅助抗抑郁药治疗的患者，转换为躁狂的比率不高于针对情绪稳定剂单一疗法的患者的报道比率。

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