Do Antidepressants Induce Rapid Cycling? A Gender-Specific Association. [CME]
J Clin Psychiatry 2003;64:814-818
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To investigate the influence of
antidepressant use and gender in the genesis of rapid-cycling
Method: The charts of bipolar patients
treated at the Massachusetts General Hospital Bipolar Clinic
(Boston, Mass.) were reviewed for gender, presence or absence of
rapid cycling, and antidepressant use prior to first mania.
Results: Data were obtained for 129
bipolar patients (55% women), 45% of whom had experienced a
rapid-cycling course. Overall, there was no significant
difference in the rates of rapid cycling between the subjects who
were exposed to antidepressants prior to their first
manic/hypomanic episode and those who were not. Additional
analysis carried out separately by gender found a significant
association between rapid cycling and antidepressant use prior to
first mania/hypomania for women but not for men. A logistic
regression analysis with rapid cycling as dependent variable
revealed a significant interaction between antidepressant use
prior to first mania/hypomania and gender.
Conclusion: We found a gender-specific
relationship between antidepressant use prior to first
manic/hypomanic episode and rapid-cycling bipolar illness. When
antidepressants are prescribed to depressed women who have a risk
of bipolar disorder, the risk of inducing rapid cycling should be
considered. Differing proportions of women and men in previous
studies may account for conflicting results reported in the
literature for the relationship of antidepressants and rapid
cycling. However, this naturalistic trial was uncontrolled, and
controlled research is required to confirm our findings.