TY - JOUR
T1 - Short Term Second-Generation Antidepressant Monotherapy in Acute Depressive Episodes of Bipolar II Disorder
T2 - A Systematic Review and Meta-Analysis T
AU - Park, Jin Hong
AU - Nuñez, Nicolas A.
AU - Gardea-Resendez, Manuel
AU - Gerberi, Danielle J.
AU - Breitinger, Scott
AU - Veldic, Marin
AU - Frye, Mark A.
AU - Singh, Balwinder
N1 - Publisher Copyright:
© 2022, MedWorks Media LLC. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Purpose: Bipolar II disorder (BD-II) has limited evidence-based treatment guidelines. The aim of this systematic review and meta-analysis was to estimate the eff icacy and safety of second-generation antidepressant (SGAD) monotherapy in acute BD-II depression. Methods: A literature search was conducted from the database incep-tion through March 2021. Only randomized controlled trials (RCTs) were included. Outcome measures included: response rates, treatment-emergent affective switch (TEAS) rates, discontinuation due to side-effects, and all-cause discontinuation. Risk ratio (RR) was calculated using the Mantel-Haenszel random effects model. Results: 3301 studies were screened, and 15 articles were selected for full-text review. Five studies met the inclusion criteria: Four double-blind RCTs (n = 533) and one open-label RCT (n = 83) were included. Two double-blind RCTs [n = 223, SGAD = 110 (venlafaxine = 65, sertraline = 45), lithium/control = 113] were included for meta-analysis. The response rate for SGAD monotherapy compared to lithium monotherapy were similar (RR = 1.44, 95% CI 0.78, 2.66). The TEAS rate for SGAD monotherapy was not signif icantly different from lithium monotherapy (p = 0.76). The discontinuation rate due to side-effects for SGAD monotherapy was signif icantly lower than lithium monotherapy with a RR = 0.32, 95% CI 0.11, 0.96, p = 0.04 but all-cause discontinuation rates were similar in both groups. Conclusions: Limited data suggests short-term eff icacy of venla-faxine and sertraline monotherapy in patients with acute BD-II depression with good side effect tolerability and without signif icantly increased switch rate. There is an urgent need for RCTs investigating the role of SGAD monotherapy in short and long-term among T patients with BD-II.
AB - Purpose: Bipolar II disorder (BD-II) has limited evidence-based treatment guidelines. The aim of this systematic review and meta-analysis was to estimate the eff icacy and safety of second-generation antidepressant (SGAD) monotherapy in acute BD-II depression. Methods: A literature search was conducted from the database incep-tion through March 2021. Only randomized controlled trials (RCTs) were included. Outcome measures included: response rates, treatment-emergent affective switch (TEAS) rates, discontinuation due to side-effects, and all-cause discontinuation. Risk ratio (RR) was calculated using the Mantel-Haenszel random effects model. Results: 3301 studies were screened, and 15 articles were selected for full-text review. Five studies met the inclusion criteria: Four double-blind RCTs (n = 533) and one open-label RCT (n = 83) were included. Two double-blind RCTs [n = 223, SGAD = 110 (venlafaxine = 65, sertraline = 45), lithium/control = 113] were included for meta-analysis. The response rate for SGAD monotherapy compared to lithium monotherapy were similar (RR = 1.44, 95% CI 0.78, 2.66). The TEAS rate for SGAD monotherapy was not signif icantly different from lithium monotherapy (p = 0.76). The discontinuation rate due to side-effects for SGAD monotherapy was signif icantly lower than lithium monotherapy with a RR = 0.32, 95% CI 0.11, 0.96, p = 0.04 but all-cause discontinuation rates were similar in both groups. Conclusions: Limited data suggests short-term eff icacy of venla-faxine and sertraline monotherapy in patients with acute BD-II depression with good side effect tolerability and without signif icantly increased switch rate. There is an urgent need for RCTs investigating the role of SGAD monotherapy in short and long-term among T patients with BD-II.
KW - antidepressants
KW - bipolar II disorder
KW - bipolar depression
KW - meta-analysis
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M3 - Article
C2 - 35721812
AN - SCOPUS:85132263830
SN - 0048-5764
VL - 52
SP - 46
EP - 72
JO - Psychopharmacology bulletin
JF - Psychopharmacology bulletin
IS - 2
ER -