Antidepressant-associated chronic irritable dysphoria (acid) in bipolar disorder: a case series

被引:40
作者
El-Mallakh, RS [1 ]
Karippot, A [1 ]
机构
[1] Univ Louisville, Sch Med, Dept Psychiat & Behav Sci, Mood Disorders Res Program, Louisville, KY 40292 USA
关键词
D O I
10.1016/j.jad.2004.08.004
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Antidepressants administered to bipolar subjects may induce manias, mixed states, or rapid cycling. More recently, we have noted that long-term use of antidepressants may induce a chronic dysphoric, irritable state. Method: A case series is presented in which six type I bipolar subjects receiving antidepressants continuously for several years developed chronic irritable dysphoria. Results: A triad of dysphoric mood, irritability, and middle insomnia that is frequently associated with occupational and social dysfunction can occur in some bipolar patients receiving antidepressants for at least 3 years. Typically, initial treatments with antidepressants for the index episode were effective. Over time, depressive symptoms returned and would transiently improve with dose increase or change of agents. Ultimately, the dysphoria and associated symptoms became chronic and resulted in dysfunction. Concomitant mood stabilizer did not appear to alter this pattern. Discontinuation of antidepressants was associated with a slow and gradual improvement in these symptoms over the ensuing year. Conclusion: Additional studies are required to investigate safety of long-term use of antidepressants in bipolar illness. (c) 2004 Elsevier B.V. All rights reserved.
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页码:267 / 272
页数:6
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