Variation in response to short-term anti-depressant treatment between patients with continuous and non-continuous cycling bipolar disorders

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Rocco de Filippis

Institute of Psychopathology, Italy

: J Spine Neurosurg

Abstract

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Objectives: The study aimed to compare effectiveness and safety of short-term antidepressant treatment between patients with continuous (CCC) and non-continuous (N-CCC) cycling bipolar disorders. Methods: The study sample included 101 patients with bipolar disorder, 22 (21.8%) CCC and 79 (78.2%) N-CCC. Response was defined as a HDRS21 total score <7 at 12 weeks of treatment and remission as a ≥50% reduction of baseline HDRS21 total score sustained for 8 weeks. Results: Compared with N-CCC patients, CCC patients achieved a significantly lower percentage of response (respectively 50% vs. 82.3%, χ2=9.6, p=0.002) and remission (respectively 40.9% vs. 69.6%, χ2=6.11, p=0.013). Adjusted logistic regression analysis indicated that CCC patients were 4.3 times more likely to be non-responders and 3.3 times more likely to be nonremitters than N-CCC patients. Concerning AD safety, 1 (5.0%) CCC patient committed a suicide attempt and AD-emerging switch was observed in 2 patients with N-CCC (2.5%) and in 1 with CCC (4.5%). Limitations: The observational nature of the study, retrospective assessment of course, and unblinded outcomes assessment. Conclusions: Our findings indicate that the presence or absence of a free interval identifies two different forms of bipolar disorders with different response not only to prophylactic treatment, as previous reported, but also to short-term ADs. We submit that clinicians should take into consideration their patients’ pattern of cycling when prescribing short- term AD treatment. Moreover, subtypes of bipolar disorders might be used as moderators of treatment response in studies assessing the efficacy or the effectiveness of antidepressant treatment.

Biography

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Rocco de Filippis completed his MD and PhD from Catholic University of the Sacred Heart in Rome. He holds a Master’s degree and he improved respectively in Bipolar Disorders and Addictive behavior in the years 2011/2012. He currently works at the Institute of Psychopathology - Rome as a Psychiatrist and Addictive Medicine, and till now worked as scientific coordinator of CME and Master of Addictive Behaviors. He currently publishes on Bipolar Disorders with high specialization on rapid cycling; he is also an official candidate at the Psychoanalytic Italian Society of the First Italian Center of Rome, and member of IPSO (International Psychoanalytic Studies Organization). He delivered an oral speech at Translational Medicine 2014 in Las Vegas on QTc Prolungation and Psychotropic Drugs