Paroxetine for bipolar depression: Outcome in patients failing prior antidepressant trials

Bipolar depression is common and often debilitating. Of particular concern are those acutely depressed bipolar patients who have not responded to previous trials of antidepressants. This investigation made use of naturalistic data collected using a standardized assessment format to determine the antidepressant efficacy and affective switch rate with paroxetine treatment far bipolar depression. The charts of 20 depressed outpatients who received paroxetine, and who met DSM-III-R criteria for bipolar disorder, were identified and data harvested pertaining to psychiatric history and presence of abnormal mood symptoms during treatment with paroxetine. All patients included had previously failed treatment with at least one standard antidepressant agent. The observed rates of antidepressant efficacy and treatment-emergent mania were 65% and 10%, respectively. These results suggest that paroxetine is an effective treatment for bipolar depression and is less likely than most other antidepressant medications to induce treatment-emergent affective switch. Depression 3:182–186 (1995). © 1995 Wiley-Liss, Inc.