Mood changes related to antidepressants: a longitudinal study of patients with bipolar disorder in a naturalistic setting

Bauer, Michael; Rasgon, Natalie; Grof, Paul; Altshuler, Lori; Gyulai, Laszlo; Lapp, Manfred; Glenn, Tasha; Whybrow, Peter C.

doi:10.1016/j.psychres.2004.08.006

Next »Psychiatry Research
Volume 133, Issue 1 , Pages 73-80, 30 January 2005

Mood changes related to antidepressants: a longitudinal study of patients with bipolar disorder in a naturalistic setting

Michael Bauer
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité-Mitte (CCM), Schumannstr. 20/21, 10117 Berlin, Germany
- Neuropsychiatric Institute & Hospital, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90024, USA
- Corresponding author. Tel.: +49 30 450 51 70 70; fax: +49 30 450 51 79 62.
Natalie Rasgon
- Neuropsychiatric Institute & Hospital, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90024, USA
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford School of Medicine, 401 Quarry Road, Room 2368, Palo Alto, CA 94305-5723, USA
Paul Grof
- Department of Psychiatry, University of Ottawa, Royal Ottawa Hospital, 1145 Carling Avenue, Ottawa, Ontario, Canada K1Z 7K4
Lori Altshuler
- Neuropsychiatric Institute & Hospital, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90024, USA
Laszlo Gyulai
- Department of Psychiatry, Bipolar Disorders Unit, University of Pennsylvania School of Medicine, 3600 Market Street, 8th Floor, Philadelphia, PA 19104, USA
Manfred Lapp
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Campus Charité-Mitte (CCM), Schumannstr. 20/21, 10117 Berlin, Germany
Tasha Glenn
- ChronoRecord Association, Inc., P.O. Box 3501, Fullerton, CA 92834, USA
Peter C. Whybrow
- Neuropsychiatric Institute & Hospital, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90024, USA

Received 5 December 2003; accepted 19 August 2004.

Abstract

This prospective, longitudinal study investigated the frequency and pattern of mood changes between outpatients receiving usual care for bipolar disorder who were either taking or not taking antidepressants. Eighty patients with bipolar disorder self-reported mood and psychiatric medications daily for 3 months using a computerized system (ChronoRecord) and returned 8662 days of data. Of the total group of 80 patients, 47 took antidepressants; 33 did not. Patients taking antidepressants reported depression twice as frequently (29% of days vs. 13.8% of days). In both groups, two-thirds of all mood changes over a 1-, 2- and 3-day period were small, between −5 and 5 on a 100-point scale. No statistically significant difference was found in the frequency of large mood changes (>10 on a 100-point scale) or in switches between depression and mania (0.7% if not taking antidepressants vs. 0.9% if taking), independent of diagnosis of bipolar I or II. Eighty-nine percent of patients taking antidepressants were also taking mood stabilizers. In this naturalistic setting, no significant difference between the rate of switches to mania or rapid cycling was found between those taking and not taking antidepressants, regardless of diagnosis. The primary difference in pattern between the groups was the time spent in depressed or normal mood, with minor daily mood variations.

Keywords: Bipolar disorder, Mania, Rapid-cycling, Switch, Self-reported mood, Antidepressants