ANALIZAN EL USO DE ANTIDEPRESIVOS EN LA ENFERMEDAD BIPOLAR
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ANALIZAN EL USO DE ANTIDEPRESIVOS EN LA ENFERMEDAD BIPOLAR

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Existen pruebas de que los antidepresivos, particularmente en la enfermedad bipolar tipo II y en especial cuando son utilizados solos, tienen efecto en el corto plazo.
Autor:
Alejandra Clark
Columnista Experto de SIIC

Institución:
University of Louisville School of Medicine


Artículos publicados por Alejandra Clark
Coautor
Riff S. El-Mallakh* 
MD, University of Louisville School of Medicine, Lousville, EE.UU.*
Recepción del artículo
25 de Enero, 2008
Aprobación
14 de Abril, 2008
Primera edición
8 de Septiembre, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Se realiza una revisión crítica de la bibliografía sobre el uso de antidepresivos en la enfermedad bipolar. Existen pruebas de que los antidepresivos, particularmente en la enfermedad bipolar tipo II y en especial cuando son utilizados solos, tienen efecto en el corto plazo. Sin embargo, numerosos estudios encontraron que cuando los antidepresivos se agregan a estabilizadores del estado de ánimo no resultan más efectivos que estos últimos solos. Además, diferentes investigaciones muestran que, en el largo plazo, invariablemente, los antidepresivos solos o asociados a los estabilizadores del estado de ánimo no reducen el riesgo de recaídas en pacientes bipolares. Al tratamiento prolongado con estas drogas se lo ha relacionado con inducción maníaca, inestabilidad en el estado de ánimo y disforia irritable crónica asociada al tratamiento crónico con antidepresivos drogas. La mejor alternativa a los antidepresivos son los estabilizadores del estado de ánimo como la lamotrigina y el litio. Drogas antipsicóticas como la quetiapina o la olanzapina asociada a fluoxetina, pueden también ser aceptables. La información acerca de nuevos agentes como pramipexol, modafinil y riluzol es prometedora.

Palabras clave
depresión, trastorno bipolar, antidepresivos


Artículo completo

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Abstract
The literature regarding the use of antidepressants in bipolar illness is critically reviewed. There is evidence, particularly for type II bipolar illness, that antidepressants, particularly when used alone, can have a therapeutic antidepressant effect in the short term. However, there are several studies that find that antidepressants added to mood stabilizers are no more effective than mood stabilizers alone. Furthermore, long-term relapse prevention trials invariably find that antidepressants, alone or added to a mood stabilizer, do not reduce the risk for depressive relapse in bipolar patients. Prolonged antidepressant treatment has been associated with manic induction, mood destabilization, and a chronic antidepressant-associated chronic irritable dysphoria (ACID). Mood stabilizers, such as lamotrigine and lithium, are the best alternative to antidepressants. Antipsychotics, such as quetiapine, or olanzapine in combination with fluoxetine, may also be reasonable. Novel agents such as pramipexole, modafinil, and riluzole, have promising acute data.

Key words
depression, bipolar illness, antidepressants


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Salud Mental
Relacionadas: Atención Primaria, Farmacología, Medicina Farmacéutica, Medicina Interna



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Enviar correspondencia a:
Riff S. El-Mallakh, Associate Professor and Director Mood Disorders Research Program Department of Psychiatry and Behavioral Sciences University of Louisville School of Medicine MedCenter One , Ky 40202, 501 East Broadway, Suite 340, Lousville, EE.UU.
Patrocinio y reconocimiento:
Esta investigación no ha recibido apoyo financiero.
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