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Review: in people with bipolar disorder, short term antidepressants improve clinical response, although tricyclics risk inducing mania

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Q What are the clinical effects of antidepressants in short term therapy of depressive episodes in people with bipolar disorder?


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Systematic review.

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Cochrane Collaboration Depression, Anxiety, and Neurosis Controlled Trials Register (December 2002), MEDLINE (1966 to present), EMBASE (1980 to present), CINAHL (1982 to present), PsycLIT (1974 to present), PSYNDEX (1977 to present), and LILACS (1982–1999) plus hand search of reference lists, papers, and textbooks covering affective disorder.

Embedded ImageStudy selection and analysis:

Inclusion criteria: double blind, randomised controlled trial (RCT) comparing antidepressants with placebo or alternative drug treatments; published in any language; people with a current depressive or mixed depressive/manic episode with or without psychotic symptoms and at least one previous episode of mania or hypomania. Analysis: pooled relative risk calculated for binary efficacy outcomes using fixed and random effects models. Heterogeneity was …

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