Paxil, Wellbutrin no better than sugar pill. Study: Antidepressants Offer No Help for Bipolar Disorder
(The New York Times News Service) — Patients seeking treatment for bipolar disorder depression are as likely to get relief from sugar pills as they are from widely used antidepressants, according to a new study.
The findings, which appear in this week’s New England Journal of Medicine, are sure to confound therapy, researchers say.
“Bipolar depression is notoriously difficult to treat,” said David Miklowitz, professor of psychology and psychiatry at the University of Colorado-Boulder, and an investigator on the study.
This study, Miklowitz said, “helps us find what does and does not work.”
In the largest study of its kind, researchers at the University of Colorado and sites across the country gave patients Paxil, Wellbutrin or a sugar pill.
During the study, all 366 participants took a mood stabilizer, which is commonly prescribed for those with bipolar disorder.
Neither the patients nor the researchers knew whether they were taking one of the two antidepressants or a placebo.
After 26 weeks, 24 percent of those taking antidepressants recovered from their depression and had no major symptoms for at least eight weeks.
Among those who took a sugar pill, 27 percent stayed well for eight weeks or more.
The study by Dr. Gary S. Sachs of Massachusetts General Hospital, is part of a seven-year, $26.8 million research project to examine the condition once known as manic-depressive illness.
During the study, funded by the National Institutes of Health, investigators at 22 sites across the country enrolled 4,361 participants. Researchers expect more results to be published soon.
About 10 million Americans suffer from bipolar disorder, characterized by extreme mood swings from elation and manic activity to incapacitating depression, according to the National Alliance on Mental Illness.
Treating bipolar disorder with antidepressants has been controversial, because some therapists worry the drugs destabilize patients, said Dr. Michael H. Allen, co-director of the mood disorders program at Colorado’s medical school and study investigator.
“Part of the problem is that there have not been very good alternatives,” Allen said.
“In the absence of other choices, people have used antidepressants, and in fact some people do very well on them,” he said.
Lacey Berumen, executive director of Colorado’s office of the National Alliance on Mental Illness, said this study should not put that issue to rest.
“I think it’s unfortunate that they limited it to only two medications,” Berumen said.
Allen said the findings should encourage new therapies.
“This may help spur better use of mood stabilizers and research into better alternatives,” such as antipsychotic drugs, he said.
“It’s a challenging disease,” Allen said. “It’s fairly easy to treat the mania and that is what’s been studied most, but actually, people spend more time depressed.”
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