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Acta Psychiatr Scand. Author manuscript; available in PMC 2009 J uly 30.
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Ghaemi et al. Page 14
Table 2
Rates of new depression with long-term treatments for bipolar disorder
Study Antidepressants (%) Controls (%) RR [95% CI]
Prien et al. (38[a]) IMI: 4/13 (30.8) Pbo: 10/13 (76.9)
0.40 [0.170.95]
*
Prien et al. (38[b]) IMI: 4/13 (30.8) Li: 6/18 (33.3) 0.92 [0.322.62]
Quitkin et al. (38) IMI +Li: 3/37 (8.1) Li: 4/38 (10.5) 0.77 [0.183.21]
Kane et al. (40[a]) IMI: 2/5 (40.0) Pbo: 4/7 (57.1) 0.70 [0.202.44]
Kane et al. (40[b]) IMI: 2/5 (40.0) Li: 1/4 (25.0) 1.60 [0.2111.9]
Kane et al. (40[c]) IMI +Li: 1/6 (16.7) Pbo: 4/7 (57.1) 0.29 [0.041.95]
Kane et al. (40[d]) IMI +Li: 1/6 (16.7) Li: 1/4 (25.0) 0.67 [0.067.85]
Prien et al. (41[a]) IMI: 10/36 (27.8) Li: 12/42 (28.6) 0.97 [0.481.98]
Prien et al. (41[b]) IMI +Li: 8/36 (22.2) Li: 12/42 (28.6) 0.78 [0.361.69]
J ohnstone et al. (41) AMI +Li: 3/5 (60.0) Li: 3/8 (37.5) 1.60 [0.515.03]
Amsterdamet al. (42) FLX: 3/8 (37.5) Pbo: 4/4 (100.0)
0.38 [0.150.92]
*
Ghaemi et al. (43) ADs +MSs: 11/32 (34.4) MSs: 17/38 (44.7) 0.77 [0.421.39]
Totals ADs MSs: 45/178 (25.3%) MSs or Pbo:
61/172 (35.5%)
0.726 [0.5470.962]
*
ADs, antidepressants; AMI, amitriptyline; FLX, fluoxetine; IMI, imipramine; Li, lithiumcarbonate; MS, mood stabilizer; Pbo, placebo.
Total N =350 patients (repeated arms counted only once). Note that 10 / 12 comparisons indicate lower risk of new depression with long-term
antidepressant, of which only 2 / 12 risk ratios (RR) as well as the pooled RR are statistically <1.0 (*), based on random-effects meta-analysis.
Different treatment arms in the same study are distinguished by alphabetical letters.
Acta Psychiatr Scand. Author manuscript; available in PMC 2009 J uly 30.
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Ghaemi et al. Page 15
Table 3
Rates of new mania with long-term treatments for bipolar disorder
Study Antidepressants (%) Controls (%) RR [95% CI]
Prien et al. (38[a]) IMI: 8/13 (61.5) Pbo: 5/13 (38.5) 1.60 [0.713.60]
Prien et al. (38[b]) IMI: 8/13 (61.5) Li: 2/18 (11.1)
5.54 [1.4021.9]
*
Quitkin et al. (38) IMI +Li: 9/37 (24.3) Li: 4/38 (10.5) 2.31 [0.786.85]
Kane et al. (40[a]) IMI: 1/5 (20.0) Pbo: 1/7 (14.3) 1.40 [0.1117.5]
Kane et al. (40[b]) IMI: 1/5 (40.0) Li: 0/4 (0.0) 2.50 [0.1348.8]
Kane et al. (40[c]) IMI +Li: 0/6 (0.0) Pbo: 1/7 (14.3) 0.38 [0.027.93]
Kane et al. (40[d]) IMI +Li: 0/6 (0.0) Li: 0/4 (0.0)
Prien et al. (41[a]) IMI: 19/36 (52.8) Li: 11/42 (26.2)
2.02 [1.113.65]
*
Prien et al. (41[b]) IMI +Li: 10/36 (27.8) Li: 11/42 (26.2) 1.06 [0.512.20]
J ohnstone et al. (41) AMI +Li: 0/5 (0.0) Li: 0/8 (0.0)
Amsterdamet al. (42) FLX: 0/8 (0.0) Pbo: 0/4 (0.0)
Ghaemi et al. (43) ADs +MSs: 6/32 (18.8) MSs: 5/38 (13.2) 1.42 [0.484.24]
Totals ADs MSs: 53/178 (29.8%) MSs or Pbo: 28/172
(16.3%)
1.72 [1.232.41]
*
Abbreviations as for Table 2.
Total N =350 trial participants (repeated arms counted only once). Note that 8/12 comparisons indicate greater risk of mania with long-termantidepressant,
of which only 2/12 risk ratios (RR) and the pooled RR are statistically >1.0 (*), based on random-effects meta-analysis.
Alphabetical letters are used to indicate different treatment arms within a study, as similarly noted for Table 2.
Acta Psychiatr Scand. Author manuscript; available in PMC 2009 J uly 30.
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Acta Psychiatr Scand. Author manuscript; available in PMC 2009 J uly 30.