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¿Influyen los antidepresivos en los patrones de estado de ánimo? Un estudio naturalista en el trastorno bipolar

Published online by Cambridge University Press:  12 May 2020

M. Bauer ,
N. Rasgon ,
P. Grof ,
T. Glenn ,
M. Lapp ,
W. Marsh ,
R. Muñoz ,
A. Suwalska ,
C. Baethge  and
T. Bschor
...Show all authors
M. Bauer
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlín, Alemania Departamento de Psiquiatría y Ciencias Bioconductuales, Instituto Semel para Neurociencia y Comportamiento Humano, Universidad de California en Los Ángeles (UCLA), Los Ángeles, CA, EE. UU.
N. Rasgon
Affiliation:
Departamento de Psiquiatría y Ciencias Bioconductuales, Instituto Semel para Neurociencia y Comportamiento Humano, Universidad de California en Los Ángeles (UCLA), Los Ángeles, CA, EE. UU. Departamento de Psiquiatría, Facultad de Medicina de Stanford, Palo Alto, CA, EE.UU.
P. Grof
Affiliation:
Clínica de Trastornos del Estado de Ánimo de Ottawa, Ottawa, Canadá
T. Glenn
Affiliation:
ChronoRecord Association, Inc. (http://www.chronorecord.org), Fullerton, CA, EE.UU.
M. Lapp
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Charité-University Medicine Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117Berlín, Alemania
W. Marsh
Affiliation:
Departamento de Psiquiatría, Facultad de Medicina de Stanford, Palo Alto, CA, EE.UU.
R. Muñoz
Affiliation:
Departamento de Psiquiatría, Universidad de California en San Diego, San Diego, CA, EE. UU.
A. Suwalska
Affiliation:
Departamento de Psiquiatría, Universidad Karol Marcinkowski de Ciencia Médica, Poznan, Polonia
C. Baethge
Affiliation:
Departamento de Psiquiatría, Universidad de Colonia, Colonia, Alemania
T. Bschor
Affiliation:
Departamento de Psiquiatría y Psicoterapia, Hospital Judío de Berlín, Berlín, Alemania
M. Alda
Affiliation:
Departamento de Psiquiatría, Universidad McGill, Montreal, Québec, Canadá
P. C. Whybrow
Affiliation:
Departamento de Psiquiatría y Ciencias Bioconductuales, Instituto Semel para Neurociencia y Comportamiento Humano, Universidad de California en Los Ángeles (UCLA), Los Ángeles, CA, EE. UU.
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Resumen

Este estudio longitudinal prospectivo comparó la frecuencia y el patrón de cambios del estado de ánimo entre pacientes ambulatorios que recibían la atención usual para el trastorno bipolar y tomaban o no tomaban antidepresivos. Ciento ochenta y dos pacientes con trastorno bipolar comunicaron su estado de ánimo y la medicación psiquiátrica durante 4 meses utilizando un sistema informático (ChronoRecord) y entregaron 22.626 días de datos. Ciento cuatro pacientes tomaban antidepresivos; 78, no. De los antidepresivos tomados, 95% eran inhibidores selectivos de la recaptación de serotonina o norepinefrina, o antidepresivos de segunda generación. De los pacientes que tomaban un antidepresivo, 91,3% tomaba concurrentemente un estabilizador del estado de ánimo. El uso de antidepresivos no influyó en la tasa diaria de cambio de depresión a manía o la tasa de ciclos rápidos, con independencia del diagnóstico de trastorno bipolar I o II. La diferencia primaria en el patrón de estado de ánimo era el tiempo en estado normal o deprimido. Los pacientes que tomaban antidepresivos con frecuencia estaban en una depresión subsíndrome. En este estudio naturalista que utilizó datos de autoinforme, los pacientes con trastorno bipolar que tomaban antidepresivos -abrumadoramente no tricíclicos y con un estabilizador del estado de ánimo concurrente- no experimentaron un aumento en la tasa de cambios a manía o ciclos rápidos comparado con los que no tomaban antidepresivos. Los antidepresivos tenían poco impacto en los patrones del estado de ánimo de los pacientes bipolares que tomaban estabilizadores del estado de ánimo.

Keywords

Trastorno bipolarAntidepresivosManíaCiclos rápidosCambioEstabilizador del estado de ánimo
Type
Original
Information
European Psychiatry (Ed. Española) , Volume 13 , Issue 7 , October 2006 , pp. 342 - 350
Copyright
Copyright © European Psychiatric Association 2006

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