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Randomized Controlled Trial
. 2006 Aug:189:124-31.
doi: 10.1192/bjp.bp.105.013045.

Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline

R M Post  1 , L L Altshuler, G S Leverich, M A Frye, W A Nolen, R W Kupka, T Suppes, S McElroy, P E Keck, K D Denicoff, H Grunze, J Walden, C M R Kitchen, J Mintz
Affiliations
Randomized Controlled Trial

Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline

R M Post et al. Br J Psychiatry. 2006 Aug.

Erratum in

  • Br J Psychiatry. 2006 Dec;189:569

Abstract

Background: Few studies have examined the relative risks of switching into hypomania or mania associated with second-generation antidepressant drugs in bipolar depression.

Aims: To examine the relative acute effects of bupropion, sertraline and venlafaxine as adjuncts to mood stabilisers.

Method: In a 10-week trial, participants receiving out-patient treatment for bipolar disorder (stratified for rapid cycling) were randomly treated with a flexible dose of one of the antidepressants, or their respective matching placebos, as adjuncts to mood stabilisers.

Results: A total of 174 adults with bipolar disorder I, II or not otherwise specified, currently in the depressed phase, were included. All three antidepressants were associated with a similar range of acute response (49-53%) and remission (34-41%). There was a significantly increased risk of switches into hypomania or mania in participants treated with venlafaxine compared with bupropion or sertraline.

Conclusions: More caution appears indicated in the use of venlafaxine rather than bupropion or sertraline in the adjunctive treatment of bipolar depression, especially if there is a prior history of rapid cycling.

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