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Pharmacotherapy for bipolar depression: comparative efficacy and acceptability is in the eye of the beholder
  1. Leslie Citrome1,
  2. Terence A Ketter2
  1. 1New York Medical College, Valhalla, New York, USA
  2. 2Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Leslie Citrome; citrome{at}cnsconsultant.com

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ABSTRACT FROM: Taylor DM, Cornelius V, Smith L, et al. Comparative efficacy and acceptability of drug treatments for bipolar depression: a multiple-treatments meta-analysis. Acta Psychiatr Scand 2014;130:452–69.

What is already known on this topic

Bipolar disorder is principally a depressive illness, given the amount of time spent symptomatic in the depressed phase.1 Despite this, there are very few approved treatments.2 Consequently, several unapproved drugs are used with varying degrees of efficacy and tolerability.

Methods of the study

The data for this study were from English language clinical trial study reports published from 1950 to April 2014. Studies that were included were randomised, double blind, 4–16 weeks, controlled trials of adults, with acute bipolar depression. Studies of refractory/resistant patients or mixed populations with mood disorders were excluded. The primary efficacy outcome was effect size. The primary acceptability outcome was ‘switch to mania’. Secondary outcomes were likelihood of response and withdrawals from trials. The direct treatment effect estimates using a random-effects model was followed by a network meta-analysis using Bayesian methodology. The rank probabilities were summarised for each drug by …

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