( cross thecountry. Unlike most clinical...)Study Sheds Light on Medication Treatment Options for Bipolar,Disorder,Health

cross the country. Unlike most clinical studies, participants were recruited from clinical settings and were included in the study even if they were being treated for co-existing disorders such as substance abuse, anxiety or psychotic symptoms. Such open recruitment criteria allows the studys results to have broader applicability than a tightly controlled trial in which people are excluded from participating if they have co-existing disorders.

Before participants were randomized to one of two antidepressants — bupropion (Wellbutrin) or paroxetine (Paxil) — or to a placebo, doctors trained in the treatment of bipolar disorder adjusted participants mood stabilizer doses to optimal levels, ensuring that they were receiving the most appropriate amount.

After about 26 weeks, Sachs and colleagues found that 24 percent of those who had been randomized to the antidepressants stayed well for at least eight consecutive weeks — the studys stringent standard for recovery; 27 percent of those randomized to a placebo stayed well long enough to meet the eight-week recovery standard, indicating no difference between adding an antidepressant or adding placebo. In addition, about 10 percent of each group experienced emerging symptoms of mania, indicating that the antidepressants did not trigger a manic switch any more than placebo. Finally, when comparing the two antidepressants to each other, both showed similar rates of response and manic switch.

Results of STEP-BD indicate that careful management of mood stabilizer medications is a reasonable alternative to adding an antidepressant medication for treating bipolar depression, said Dr. Sachs.

Future STEP-BD results will shed light on other treatment options for bipolar disorder, including psychotherapeutic treatments.

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More
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