SynthesisActa psychiatrica Scandinavica2008
Long-term antidepressant treatment in bipolar disorder: meta-analyses of benefits and risks.
Synthesis in Acta psychiatrica Scandinavica, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 171 citations in OpenAlex.
- Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry.European archives of psychiatry and clinical neuroscience · 2012Pooled it
- Depression and Suicidality Outcomes in the Treatment of Early Age Mania Study.Journal of the American Academy of Child and Adolescent Psychiatry · 2015Trial
- Efficacy and mood conversion rate of short-term fluoxetine monotherapy of bipolar II major depressive episode.Journal of clinical psychopharmacology · 2010Trial
- Article
- Antidepressants in the treatment of bipolar depression: commentary.The international journal of neuropsychopharmacology · 2025Review
- Prospective, comparative, pilot study of maintenance treatment in comorbid bipolar disorders with post-traumatic stress disorder.International clinical psychopharmacology · 2025Article
- Risk of Switch to Mania/Hypomania in Bipolar Depressive Patients Treated with Antidepressants: A Real-World Study.Health data science · 2025Article
- Mood regulation in euthymic patients with a history of antidepressant-induced mania.Bipolar disorders · 2024Article
- Comparison of the efficacy of venlafaxine and bupropion in the treatment of depressive episode in patients with bipolar II disorder.Journal of family medicine and primary care · 2023Article
- Antidepressant Treatment and Manic Switch in Bipolar I Disorder: A Clinical and Molecular Genetic Study.Journal of personalized medicine · 2022Article
- Screening of Mood Symptoms Using MMPI-2-RF Scales: An Application of Machine Learning Techniques.Journal of personalized medicine · 2021Article
- Bipolar depression: a major unsolved challenge.International journal of bipolar disorders · 2020Review
- Pharmacological treatment of adult bipolar disorder.Molecular psychiatry · 2019Review
- Risk of manic switch with antidepressants use in patients with bipolar disorder in a Nigerian neuropsychiatric hospital.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2018Article
- Antidepressants and Mood Stabilizers: Novel Research Avenues and Clinical Insights for Bipolar Depression.International journal of molecular sciences · 2017Review
- Treatment-emergent hypomania possibly associated with over-the-counter supplements.The mental health clinician · 2017Article
- Athanasios Koukopoulos' Psychiatry: The Primacy of Mania and the Limits of Antidepressants.Current neuropharmacology · 2017Review
- The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features.Current neuropharmacology · 2017Observational
- The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment.Journal of affective disorders · 2017Review
- The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm.The international journal of neuropsychopharmacology · 2017Review
Corrections and comments
- Commented on by
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveLong-term antidepressant (AD) treatment for depression in bipolar disorder (BPD) patients is highly prevalent, but its benefits and risks remain uncertain, encouraging this meta-analysis of available research.
methodWe reviewed randomized controlled trials for BPD involving >or=6 months of treatment with AD +/- mood stabilizer (MS) vs. placebo +/- MS, using meta-analyses to compare reported risks of new depression vs. mania.
resultsIn seven trials (350 BPD patients) involving 12 contrasts, long-term treatments that included ADs yielded 27% lower risk of new depression vs. MS-only or no treatment [pooled relative risk, RR = 0.73; 95% CI 0.55-0.97; number-needed-to-treat (NNT) = 11], but 72% greater risk for new mania [RR = 1.72; 95% CI 1.23-2.41; number-needed-to-harm (NNH) = 7]. Compared with giving an MS-alone, adding an AD yielded neither major protection from depression (RR = 0.84; 95% CI 0.56-1.27; NNT = 16) nor substantial increase in risk of mania (RR = 1.37; 95% CI 0.81-2.33; NNH = 16).
conclusionLong-term adjunctive AD treatment was not superior to MS-alone in BPD, further encouraging reliance on MSs as the cornerstone of prophylaxis.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.