The international society for bipolar disorders (ISBD) task force report on antidepressant use in bipolar diosrders

Pacchiarotti, Isabella, Bond, David J., Baldessarini, Ross, Nolen, Willem, Grunze, Heinz, Licht, Rasmus W., Post, Robert M., Berk, Michael, Goodwin, Guy M., Sachs, Gary S., Tondo, Leonardo, Findling, Robert L., Youngstrom, Eric A., Tohen, Mauricio, Undurraga, Juan, Gonzalez-Pinto, Ana, Goldberg, Joseph F., Yildiz, Aysegul, Altshuler, Lori L., Calabrese, Joseph R., Mitchell, Philip B., Thase, Michael, Koukopoulos, Athanasios, Colom, Francesc, Frye, Mark A., Malhi, Gin S., Fountoulaskis, Konstantinos N., Vazquez, Gustavo, Perlis, Roy H., Ketter, Terence A., Cassidy, Frederick, Akiskal, Hagop, Azorin, Jen-Michel, Valenti, Marc, Mazzei, Diego, Lafer, Beny, Kato, Tadafumi, Mazzarini, Lorenzo, Martinez-Aran, Anabel, Parker, Gordon, Souery, Daniel, Ozerdem, Aysegul, McElroy, Susan, Girardi, Paolo, Bauer, Michael, Yatham, Lakshmi, Zarate, Carlos A., Nierenberg, Andrew A., Birmaher, Boris, Kanba, Shigenobu, El-Mallakh, Rif S., Serretti, Alessandro, Rihmer, Zoltan, Young, Allan H., Kotzalidis, Georgios D., MacQueen, Glenda M., Bowden, Charles L., Ghaemi, S. Nassir, Lopez-Jaramillo, Carlos, Rybakowski, Janusz, Kyooseob, Ha, Perugi, Giulio, Kasper, Siegfried, Amsterdam, Jay D., Hirschfeld, Robert M., Kapczinski, Flavio and Vieta, Eduard 2013, The international society for bipolar disorders (ISBD) task force report on antidepressant use in bipolar diosrders, American journal of psychiatry, vol. 170, no. 11, pp. 1249-1262, doi: 10.1176/appi.ajp.2013.13020185.

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Title The international society for bipolar disorders (ISBD) task force report on antidepressant use in bipolar diosrders
Author(s) Pacchiarotti, Isabella
Bond, David J.
Baldessarini, Ross
Nolen, Willem
Grunze, Heinz
Licht, Rasmus W.
Post, Robert M.
Berk, MichaelORCID iD for Berk, Michael
Goodwin, Guy M.
Sachs, Gary S.
Tondo, Leonardo
Findling, Robert L.
Youngstrom, Eric A.
Tohen, Mauricio
Undurraga, Juan
Gonzalez-Pinto, Ana
Goldberg, Joseph F.
Yildiz, Aysegul
Altshuler, Lori L.
Calabrese, Joseph R.
Mitchell, Philip B.
Thase, Michael
Koukopoulos, Athanasios
Colom, Francesc
Frye, Mark A.
Malhi, Gin S.
Fountoulaskis, Konstantinos N.
Vazquez, Gustavo
Perlis, Roy H.
Ketter, Terence A.
Cassidy, Frederick
Akiskal, Hagop
Azorin, Jen-Michel
Valenti, Marc
Mazzei, Diego
Lafer, Beny
Kato, Tadafumi
Mazzarini, Lorenzo
Martinez-Aran, Anabel
Parker, Gordon
Souery, Daniel
Ozerdem, Aysegul
McElroy, Susan
Girardi, Paolo
Bauer, Michael
Yatham, Lakshmi
Zarate, Carlos A.
Nierenberg, Andrew A.
Birmaher, Boris
Kanba, Shigenobu
El-Mallakh, Rif S.
Serretti, Alessandro
Rihmer, Zoltan
Young, Allan H.
Kotzalidis, Georgios D.
MacQueen, Glenda M.
Bowden, Charles L.
Ghaemi, S. Nassir
Lopez-Jaramillo, Carlos
Rybakowski, Janusz
Kyooseob, Ha
Perugi, Giulio
Kasper, Siegfried
Amsterdam, Jay D.
Hirschfeld, Robert M.
Kapczinski, Flavio
Vieta, Eduard
Journal name American journal of psychiatry
Volume number 170
Issue number 11
Start page 1249
End page 1262
Total pages 14
Publisher American Psychiatric Association
Place of publication Arlington, Virginia
Publication date 2013-11-01
ISSN 0002-953X
Summary Objective:
The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations on the use of antidepressants in bipolar disorders.

An expert task force iteratively developed consensus through serial consensus-based revisions using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new or reworded items and items that needed to be rerated. This process resulted in the final ISBD Task Force clinical recommendations on antidepressant use in bipolar disorder.

There is striking incongruity between the wide use of and the weak evidence base for the efficacy and safety of antidepressant drugs in bipolar disorder. Few well-designed, long-term trials of prophylactic benefits have been conducted, and there is insufficient evidence for treatment benefits with antidepressants combined with mood stabilizers. A major concern is the risk for mood switch to hypomania, mania, and mixed states. Integrating the evidence and the experience of the task force members, a consensus was reached on 12 statements on the use of antidepressants in bipolar disorder.

Because of limited data, the task force could not make broad statements endorsing antidepressant use but acknowledged that individual bipolar patients may benefit from antidepressants. Regarding safety, serotonin reuptake inhibitors and bupropion may have lower rates of manic switch than tricyclic and tetracyclic antidepressants and norepinephrine-serotonin reuptake inhibitors. The frequency and severity of antidepressant-associated mood elevations appear to be greater in bipolar I than bipolar II disorder. Hence, in bipolar I patients antidepressants should be prescribed only as an adjunct to mood-stabilizing medications.
Language eng
DOI 10.1176/appi.ajp.2013.13020185
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, American Psychiatric Publishing
Persistent URL

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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Created: Tue, 12 Nov 2013, 14:23:44 EST by Jane Moschetti

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