Antidepressant Treatment for Acute Bipolar Depression: An Update

Table 1

Summary of recent studies examining the efficacy of antidepressants in the treatment of acute bipolar depression.

Positive studies				Negative studies
Study	No. of participants	Drug	Comments	Study	No. of participants	Drug	Comments
Antidepressants as monotherapy
Amsterdam and Shults 2005 [13]	34 (BPI=32, BPII=2)	Fluoxetine, olanzapine/fluoxetine combination	No placebo control	McElroy et al. 2010 (EMBOLDEN II) [14]	740 (BPI=478, BPII=262)	Paroxetine
Parker et al. 2006 [16]	10 BPII	Escitalopram	Small sample size
Agosti and Stewart 2007 [21]	70 BP II	Imipramine, phenelzine	No significance demonstrated
Amsterdam and Shults 2008 [17]	83 BPII	Venlafaxine	No placebo control
Amsterdam and Shults 2010 [15]	148 BPII	Fluoxetine	No placebo control
Antidepressants with mood stabilizers
Schaffer et al. 2006 [27]	20	Citalopram	Small sample size, no placebo control	Sachs et al. 2007 [29]	366 (BPI=240, BPII=114)	Paroxetine, bupropion
Fonseca et al. 2006 [28]	20	Escitalopram	Small sample size, no placebo control	Sidor et al. 2011 [32]	1,034 (Meta- Analysis)	Fluoxetine, paroxetine, bupropion, imipramine
Tamayo et al. 2009 [46]	114	Olanzapine/fluoxetine combination	Conducted by Lilly Research Laboratories
Pilhatsch et al. 2010 [41]	40	Paroxetine, amitriptyline	No placebo control
Perlis et al. 2010 [45]	410	Olanzapine/fluoxetine combination	Conducted by Lilly Research Laboratories