Treatment of Bipolar Depression: A Survey of Canadian Psychiatrists

1997 ◽  
Vol 42 (3) ◽  
pp. 298-302 ◽  
Author(s):  
Verinder Sharma ◽  
Dwight S Mazmanian ◽  
Emmanuel Persad ◽  
Karen M Kueneman
Keyword(s):  
Bipolar Disorder ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Treatment Approach ◽  
Bipolar Depression ◽  
Treatment Strategies ◽  
Lithium Carbonate ◽  
Somatic Therapy ◽  
Somatic Therapies

Objective This study was conducted to examine how Canadian psychiatrists manage bipolar depression. Method A questionnaire specific to the treatment of bipolar depression was mailed to 1639 active members of the Canadian Psychiatric Association. Results Seven hundred and sixty-six completed questionnaires were returned (46.7%). Most psychiatrists indicated that a combination of psychotherapy and somatic therapy was their preferred approach. For bipolar disorder, depressed, lithium carbonate and selective serotonin reuptake inhibitors (SSRIs) were the preferred treatment strategies. For substitution, tricyclic antidepressants (TCAs) were the favoured choice. Lithium carbonate was the preferred choice for augmentation and addition. Conclusion These findings indicate that a combination of psychotherapy and somatic therapy is the preferred treatment approach for bipolar depression. Lithium carbonate and SSRIs are the favoured somatic therapies.

Abstract WP167: Effects of Selective Serotonin Reuptake Inhibitors versus Tricyclic Antidepressants on Cerebrovascular Events

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Jou Wei Lin ◽  
Chia-Hsuin Chang ◽  
Chin-Hsien Lin
Keyword(s):  
Confidence Interval ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Hazard Ratio ◽  
Serotonin Reuptake Inhibitors ◽  
Adjusted Hazard Ratio ◽  
Selective Serotonin ◽  
Cerebrovascular Events ◽  
Reduced Risk

Background: The objective of this study was to examine the effects of selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) on cerebrovascular events in patients with depression or anxiety. Methods: We performed a retrospective cohort study in a nationwide population. The patients who started to take SSRIs and TCAs with a diagnosis of depression or anxiety between January 1, 2001 and December 31, 2009 were identified from the Taiwan National Health Insurance claims database. We examined the association between the two types of antidepressants and incidence of stroke using a proportional hazard model adjusted for risk factors for stroke. Results: Among of the 24,662 SSRI and 14,736 TCA initiators, the crude incidence rate for stroke was 10.03 and 13.77 per 100 person-years respectively. SSRI use was associated with a significantly reduced risk as compared with TCAs with the adjusted hazard ratio of 0.67 (95% confidence interval 0.47 to 0.96) in a dose-dependent manner. No significant effect modification was found among subgroups, such as hypertension, diabetes, previous cardiovascular and cerebrovascular diseases. The adjusted hazard ratio was 1.09 (95% confidence interval 0.65 to 1.85) for those aged more than 65 years, suggesting only a potential trend for a higher risk of stroke with SSRIs in the geriatric group. Conclusions: As compared with TCAs, the use of SSRIs was associated with a reduced risk for cerebrovascular events in a clear dose-response manner. Further researches are needed to examine the potential risk and benefit of SSRI use for patients with high risk of stroke.

scholarly journals Should we stop using tricyclic antidepressants in pregnancy?

2010 ◽  
Vol 41 (1) ◽  
pp. 15-17 ◽  
Author(s):  
C. M. Pariante ◽  
G. Seneviratne ◽  
L. Howard
Keyword(s):  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Swedish Study ◽  
In Pregnancy

A new Swedish study by Reis & Källén describes approximately 15 000 women (and their babies) that, between 1995 and 2007, reported the use of antidepressants, or were prescribed such drugs, during pregnancy. In this study, pregnancy and teratogenic outcomes after exposure to tricyclic antidepressants are, for most measures, equal or worse than after exposure to selective serotonin reuptake inhibitors or other antidepressants. Based on this and on a review of the few other studies available (admittedly, a relatively small number of women on which conclusions can be based), the authors of this Editorial challenge the ‘perinatal myth’ that tricyclics are the safest choice in pregnancy.

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