[ { "key": "DZABGDX5", "version": 17, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/DZABGDX5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/DZABGDX5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } }, "creatorSummary": "Zhang et al.", "parsedDate": "2013-11-05", "numChildren": 1 }, "data": { "key": "DZABGDX5", "version": 17, "itemType": "journalArticle", "title": "Antidepressants for bipolar disorder: A meta-analysis of randomized, double-blind, controlled trials", "creators": [ { "creatorType": "author", "firstName": "Yingli", "lastName": "Zhang" }, { "creatorType": "author", "firstName": "Huan", "lastName": "Yang" }, { "creatorType": "author", "firstName": "Shichang", "lastName": "Yang" }, { "creatorType": "author", "firstName": "Wei", "lastName": "Liang" }, { "creatorType": "author", "firstName": "Ping", "lastName": "Dai" }, { "creatorType": "author", "firstName": "Changhong", "lastName": "Wang" }, { "creatorType": "author", "firstName": "Yalin", "lastName": "Zhang" } ], "abstractNote": "OBJECTIVE:\nTo examine the efficacy and safety of short-term and long-term use of antidepressants in the treatment of bipolar disorder.\n\nDATA SOURCES:\nA literature search of randomized, double-blind, controlled trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Controlled Trials databases. The keywords “bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder”, AND “antidepressant agent, antidepressive agents second- generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake inhibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent” were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented.\n\nSTUDY SELECTION:\nStudies selected were double-blind randomized controlled trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. All participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsychotics in the experimental group were excluded. All analyses were conducted using Review Manager 5.1 provided by the Cochrane Collaboration.\n\nMAIN OUTCOME MEASURES:\nThe primary outcome was the response and switching to mania. The secondary outcomes included remission, discontinuation rate, and suicidality.\n\nRESULTS:\nAmong 5 001 treatment studies published, 14 double-blind randomized controlled trials involving 1 244 patients were included in the meta-analysis. Eleven short-term studies and three maintenance studies were included. Studies suggested that patients treated with antidepressants were not significantly more likely to achieve higher response and remission rates in the short-term or long-term treatment than patients treated with placebo and other medications. Antidepressants were not associated with an increased risk of discontinuation, relapse or suicidality. When one antidepressant was compared with another, no significant difference in efficacy and tolerability was found.\n\nCONCLUSION:\nExisting evidence of efficacy does not support the short-term or long-term application of antidepressant therapy in patients with bipolar disorder, although the tolerability and safety of antidepressants have been generally acknowledged. There is a need for large-sample, double-blind, randomized controlled trials to elucidate the role of antidepressants in patients with different subcategories of bipolar disorder.", "publicationTitle": "Neural Regeneration Research", "publisher": "", "place": "", "date": "2013-11-05", "volume": "8", "issue": "31", "section": "", "partNumber": "", "partTitle": "", "pages": "2962-2974", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Neural Regen Res", "DOI": "10.3969/j.issn.1673-5374.2013.31.009", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146170/", "accessDate": "2015-10-10T05:13:44Z", "PMID": "", "PMCID": "", "ISSN": "1673-5374", "archive": "", "archiveLocation": "", "shortTitle": "Antidepressants for bipolar disorder", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 25206617\nPMCID: PMC4146170", "tags": [], "collections": [ "JPBI5EW9" ], "relations": {}, "dateAdded": "2015-10-10T05:13:44Z", "dateModified": "2015-10-10T05:13:44Z" } }, { "key": "W7VJTDFH", "version": 17, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/W7VJTDFH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/W7VJTDFH", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/386208/items/DZABGDX5", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "W7VJTDFH", "version": 17, "parentItem": "DZABGDX5", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed 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"href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "PGUCR7QQ", "version": 16, "parentItem": "QFUDXRSC", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Full Text PDF", "accessDate": "2015-10-10T05:09:43Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2302832/pdf/nihms39250.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-10-10T05:09:43Z", "dateModified": "2015-10-10T05:09:43Z" } }, { "key": "8DRSRP9I", "version": 16, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/8DRSRP9I", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/8DRSRP9I", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/386208/items/QFUDXRSC", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "8DRSRP9I", "version": 16, "parentItem": "QFUDXRSC", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2015-10-10T05:09:43Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2302832/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-10-10T05:09:43Z", "dateModified": "2015-10-10T05:09:43Z" } }, { "key": "QFUDXRSC", "version": 16, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/QFUDXRSC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/QFUDXRSC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } }, "creatorSummary": "Phillips et al.", "parsedDate": "2008-03", "numChildren": 2 }, "data": { "key": "QFUDXRSC", "version": 16, "itemType": "journalArticle", "title": "Medication Effects in Neuroimaging Studies of Bipolar Disorder", "creators": [ { "creatorType": "author", "firstName": "Mary L.", "lastName": "Phillips" }, { "creatorType": "author", "firstName": "Michael J.", "lastName": "Travis" }, { "creatorType": "author", "firstName": "Andrea", "lastName": "Fagiolini" }, { "creatorType": "author", "firstName": "David J.", "lastName": "Kupfer" } ], "abstractNote": "Objective\nNeuroimaging studies are promising components for a new diagnostic framework for bipolar disorder, but a major issue is the potential confound of psychotropic medication upon experimental measures. Withdrawing all individuals from medication and examining only unmedicated individuals may be clinically unfeasible, and examining only unmedicated individuals may render findings less generalizable.\n\nMethod\nThe authors review structural and functional neuroimaging studies of medicated and unmedicated patients with bipolar disorder to discern the possible confounding effect of medication.\n\nResults\nFindings from studies identified on MEDLINE that included medicated individuals with bipolar disorder indicated either no significant effect or ameliorative effects of psychotropic medications on abnormal structural and functional neuroimaging measures relevant to pathophysiologic mechanisms of the disorder. Different strategies for assessing medication effects are compared.\n\nConclusions\nNeuroimaging studies of bipolar disorder ideally should recruit both unmedicated and medicated individuals. Individuals who are unable to tolerate medication withdrawal likely have more severe illness and are especially informative for research examining biomarkers of illness and treatment response.", "publicationTitle": "The American journal of psychiatry", "publisher": "", "place": "", "date": "2008-3", "volume": "165", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "313-320", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Psychiatry", "DOI": "10.1176/appi.ajp.2007.07071066", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2302832/", "accessDate": "2015-10-10T05:09:43Z", "PMID": "", "PMCID": "", "ISSN": "0002-953X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 18245175\nPMCID: PMC2302832", "tags": [], "collections": [ "JPBI5EW9" ], "relations": {}, "dateAdded": "2015-10-10T05:09:43Z", "dateModified": "2015-10-10T05:09:43Z" } }, { "key": "AF3F2JII", "version": 15, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/AF3F2JII", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/AF3F2JII", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/386208/items/K8R465WZ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "AF3F2JII", "version": 15, "parentItem": "K8R465WZ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Full Text PDF", "accessDate": "2015-10-10T04:27:02Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272786/pdf/DRT2012-684725.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-10-10T04:27:02Z", "dateModified": "2015-10-10T04:27:02Z" } }, { "key": "JT5Z7IP6", "version": 15, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/JT5Z7IP6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/JT5Z7IP6", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/386208/items/K8R465WZ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "JT5Z7IP6", "version": 15, "parentItem": "K8R465WZ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2015-10-10T04:27:02Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272786/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-10-10T04:27:02Z", "dateModified": "2015-10-10T04:27:02Z" } }, { "key": "K8R465WZ", "version": 15, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/K8R465WZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/K8R465WZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } }, "creatorSummary": "Amit and Weizman", "parsedDate": "2012", "numChildren": 2 }, "data": { "key": "K8R465WZ", "version": 15, "itemType": "journalArticle", "title": "Antidepressant Treatment for Acute Bipolar Depression: An Update", "creators": [ { "creatorType": "author", "firstName": "Ben H.", "lastName": "Amit" }, { "creatorType": "author", "firstName": "Abraham", "lastName": "Weizman" } ], "abstractNote": "While studies in the past have focused more on treatment of the manic phase of bipolar disorder (BD), recent findings demonstrate the depressive phase to be at least as debilitating. However, in contrast to unipolar depression, depression in bipolar patients exhibits a varying response to antidepressants, raising questions regarding their efficacy and tolerability. Methods. We conducted a MEDLINE and Cochrane Collaboration Library search for papers published between 2005 and 2011 on the subject of antidepressant treatment of bipolar depression. Sixty-eight articles were included in the present review. Results. While a few studies did advocate the use of antidepressants, most well-controlled studies failed to show a robust effect of antidepressants in bipolar depression, regardless of antidepressant class or bipolar subtype. There was no significant increase in the rate of manic/hypomanic switch, especially with concurrent use of mood stabilizers. Prescribing guidelines published in recent years rely more on atypical antipsychotics, especially quetiapine, as a first-line therapy. Conclusions. Antidepressants probably have no substantial role in acute bipolar depression. However, in light of conflicting results between studies, more well-designed trials are warranted.", "publicationTitle": "Depression Research and Treatment", "publisher": "", "place": "", "date": "2012", "volume": "2012", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Depress Res Treat", "DOI": "10.1155/2012/684725", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272786/", "accessDate": "2015-10-10T04:27:02Z", "PMID": "", "PMCID": "", "ISSN": "2090-1321", "archive": "", "archiveLocation": "", "shortTitle": "Antidepressant Treatment for Acute Bipolar Depression", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 22319648\nPMCID: PMC3272786", "tags": [], "collections": [ "JPBI5EW9" ], "relations": {}, "dateAdded": "2015-10-10T04:27:02Z", "dateModified": "2015-10-10T04:27:02Z" } }, { "key": "BTQMVCXU", "version": 14, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/BTQMVCXU", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/BTQMVCXU", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } }, "creatorSummary": "Correll et al.", "parsedDate": "2015-06", "numChildren": 1 }, "data": { "key": "BTQMVCXU", "version": 14, "itemType": "journalArticle", "title": "Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder", "creators": [ { "creatorType": "author", "firstName": "Christoph U", "lastName": "Correll" }, { "creatorType": "author", "firstName": "Johan", "lastName": "Detraux" }, { "creatorType": "author", "firstName": "Jan", "lastName": "De Lepeleire" }, { "creatorType": "author", "firstName": "Marc", "lastName": "De Hert" } ], "abstractNote": "People with severe mental illness have a considerably shorter lifespan than the general population. This excess mortality is mainly due to physical illness. Next to mental illness-related factors, unhealthy lifestyle, and disparities in health care access and utilization, psychotropic medications can contribute to the risk of physical morbidity and mortality. We systematically reviewed the effects of antipsychotics, antidepressants and mood stabilizers on physical health outcomes in people with schizophrenia, depression and bipolar disorder. Updating and expanding our prior systematic review published in this journal, we searched MEDLINE (November 2009 - November 2014), combining the MeSH terms of major physical disease categories (and/or relevant diseases within these categories) with schizophrenia, major depressive disorder and bipolar disorder, and the three major psychotropic classes which received regulatory approval for these disorders, i.e., antipsychotics, antidepressants and mood stabilizers. We gave precedence to results from (systematic) reviews and meta-analyses wherever possible. Antipsychotics, and to a more restricted degree antidepressants and mood stabilizers, are associated with an increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, haematological, musculoskeletal and renal diseases, as well as movement and seizure disorders. Higher dosages, polypharmacy, and treatment of vulnerable (e.g., old or young) individuals are associated with greater absolute (elderly) and relative (youth) risk for most of these physical diseases. To what degree medication-specific and patient-specific risk factors interact, and how adverse outcomes can be minimized, allowing patients to derive maximum benefits from these medications, requires adequate clinical attention and further research.", "publicationTitle": "World Psychiatry", "publisher": "", "place": "", "date": "2015-6", "volume": "14", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "119-136", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "World Psychiatry", "DOI": "10.1002/wps.20204", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471960/", "accessDate": "2015-10-10T04:18:10Z", "PMID": "", "PMCID": "", "ISSN": "1723-8617", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 26043321\nPMCID: PMC4471960", "tags": [], "collections": [ "JPBI5EW9" ], "relations": {}, "dateAdded": "2015-10-10T04:18:10Z", "dateModified": "2015-10-10T04:18:10Z" } }, { "key": "IZ2M6NNJ", "version": 14, "library": { "type": "group", "id": 386208, "name": "Metodos trastornos del estado de animo", "links": { "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/386208/items/IZ2M6NNJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/metodos_trastornos_del_estado_de_animo/items/IZ2M6NNJ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/386208/items/BTQMVCXU", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } } }, "data": { "key": "IZ2M6NNJ", "version": 14, "parentItem": "BTQMVCXU", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed 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} }, "meta": { "createdByUser": { "id": 2578509, "username": "Silvanacs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/silvanacs", "type": "text/html" } } }, "creatorSummary": "Leon et al.", "parsedDate": "2014-07", "numChildren": 1 }, "data": { "key": "BT8CKPPD", "version": 13, "itemType": "journalArticle", "title": "Risk of Suicidal Behavior With Antidepressants in Bipolar and Unipolar Disorders", "creators": [ { "creatorType": "author", "firstName": "Andrew C", "lastName": "Leon" }, { "creatorType": "author", "firstName": "Jess G.", "lastName": "Fiedorowicz" }, { "creatorType": "author", "firstName": "David A.", "lastName": "Solomonon" }, { "creatorType": "author", "firstName": "Chunshan", "lastName": "Li" }, { "creatorType": "author", "firstName": "William H.", "lastName": "Coryell" }, { "creatorType": "author", "firstName": "Jean", "lastName": "Endicott" }, { "creatorType": "author", "firstName": "Jan", "lastName": "Fawcett" }, { "creatorType": "author", "firstName": "Martin B.", "lastName": "Keller" } ], "abstractNote": "Objective\nTo examine the risk ofsuicidal behavior (suicide attempts and deaths) associated with antidepressants in participants with bipolar I, bipolar n, and unipolar major depressive disorders.\n\nDesign\nA 27-year longitudinal (1981-2008) observational study ofmood disorders (Research Diagnostic Criteria diagnoses based on Schedule Dr Afi:ctive Disorders and Schizophrenia and review ofmedical records) was used to evaluate antidepressants and risk Dr suicidal behavior. Mixed-efi:cts logistic regression models examined propensity Dr antidepressant exposure. Mixed-efi:cts swvival models that were matched on the propensity score examined exposure status as a risk factor for time until suicidal behavior.\n\nSetting\nFive US academic medical centers.\n\nResults\nAnalyses of206 participants with bipolar I disorder revealed 2,010 exposure intervals (980 exposed to antidepressants; 1,030 unexposed); 139 participants with bipolar II disorder had 1 ,407 exposure intervals (694 exposed; 713 unexposed); and 361 participants with unipolar depressive disorder had 2, 745 exposure intervals (1,328 exposed; 1,417 unexposed). Propensity score analyses confinned that more severely ill participants were more likely to initiate antidepressant treatment. In mixed-elects swvival analyses, those with bipolar I disorder had a significant reduction in risk of suicidal behavior by 54% (HR = 0.46; 95% CI, 0.31-0.69; t = -3.74; P < .001) during periods of antidepressant exposure compared to propensity-matched unexposed intervals. Similarly, the risk was reduced by 35% (HR = 0.65; 95% CI, 0.43-0.99; t = −2.01; P = .045) in bipolar II disorder. By contrast, there was no evidence of an increased or decreased risk with antidepressant exposure in unipolar disorder.\n\nCondusions\nBased on obsetVational data adjusted Dr propensity to receive antidepressants, antidepressants may protect patients with bipolar disorders but not unipolar depressive disorder from suicidal behavior.", "publicationTitle": "The Journal of clinical psychiatry", "publisher": "", "place": "", "date": "2014-7", "volume": "75", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "720-727", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Clin Psychiatry", "DOI": "10.4088/JCP.13m08744", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142755/", "accessDate": "2015-10-10T04:02:43Z", "PMID": "", "PMCID": "", "ISSN": "0160-6689", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 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