Evidence map›Paper›PMID 34327873›Full record

ReviewBrain and behavior2021

Neglected but not negligible aspects of antidepressants and their availability in bipolar depression.

Takeshi Terao

Abstract readReview
In one paragraph

Review in Brain and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Takeshi TeraoDepartment of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Oita, Japan.ORCID 0000-0001-7545-4304

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesAlthough many antidepressants are available, they are not always used appropriately. For appropriate use of antidepressants, the old concept of a linear dose-response relationship, in which the dose is linearly increased to achieve a sufficient antidepressant effect, should be reconsidered. Furthermore, there is ongoing debate on the safe and appropriate use of antidepressants in patients with bipolar depression. Antidepressants may be used under certain conditions in patients with bipolar depression. These neglected-but not negligible-aspects of antidepressants have been discussed herein.

methodsA narrative qualitative review

resultsDose-response relationships of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are not linear. They may be bell-shaped, with efficacy initially increasing with an increase in dose but decreasing when the dose is increased beyond a certain point. Despite using international diagnostic criteria, uncertainty remains on whether operationally diagnosed depression is latent bipolar I depression, latent bipolar II depression, or true depression. Furthermore, operationally diagnosed bipolar II depression may be latent bipolar I depression, true bipolar II depression, or depression with false hypomanic episodes. Manic/hypomanic switches are most likely to occur in patients receiving tricyclic antidepressants, followed by those receiving serotonin and noradrenaline reuptake inhibitors and SSRIs, in that order. Also, these switches are most likely to occur in patients with bipolar I depression, followed by those with bipolar II depression and true depression, in that order.

conclusionsConsidering the diagnostic subtype of bipolar depression and antidepressant properties may help to determine the optimal treatment strategy.

Indexed as

Bipolar DisorderAntidepressive AgentsAntidepressive Agents, TricyclicDepressionHumansSelective Serotonin Reuptake InhibitorsSerotoninAntidepressive AgentsAntidepressive Agents, TricyclicSelective Serotonin Reuptake InhibitorsSerotonin5-HT1A autoreceptorantidepressantsbipolar depressiondose-response relationshipselective serotonin reuptake inhibitors

Identifiers

PMID34327873
PMCPMC8413745

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Registered trials

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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.