ReviewCurrent neuropharmacology2017
Athanasios Koukopoulos' Psychiatry: The Primacy of Mania and the Limits of Antidepressants.
Review in Current neuropharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Agitated Depression Associated With Flurazepam Discontinuation.Case reports in psychiatry · 2024Article
- What Came First, Mania or Depression? Polarity at Onset in Bipolar I and II: Temperament and Clinical Course.Brain sciences · 2023Article
- Depression Preceding Diagnosis of Bipolar Disorder.Frontiers in psychiatry · 2020Review
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
backgroundAthanasios Koukopoulos provided a radical model for understanding depressive and manic conditions.
objectiveTo review, explain, and analyze Koukopoulos' concept of the primacy of mania, with special attention to the role of antidepressants.
methodA conceptual review of Koukopoulos' writings and lectures on this topic is given.
resultsKoukopoulos held that depressive states are caused by manic states; the former do not occur without the latter. The most common scenario of the inseparability of depressive and manic symptoms occurs in mixed states, which we estimate to represent about one-half of all depressive episodes in all patients (not just bipolar illness). In a review of the empirical evidence for this topic, we conclude that empirical evidence exists to support the primary of mania thesis in almost 80% of depressed patients. Since antidepressants worsen mania, they would be expected to worsen depression as well in this model. We provide evidence that supports this view in most persons with depressive states.
conclusionKoukopoulos' model of affective illness is one where manic states are the primary pathology, and depressive conditions are a secondary consequence. Hence treatment of depression with antidepressants would be less effective than treatment with mood stabilizers, since treating an effect is less successful than treating its cause. This approach would reverse current assumptions in psychiatry.
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