Adjunctive antidepressants for the treatment of bipolar depression: An updated meta-analysis of randomized clinical trials

Arman Shafiee; Hassan Moltazemi; Mohammad Javad Amini; Omid Kohandel Gargari; Farima Safari; Faeze Soltani Abhari; Kyana Jafarabady; Mahmood Bakhtiyari

doi:10.1016/j.ajp.2023.103839

Adjunctive antidepressants for the treatment of bipolar depression: An updated meta-analysis of randomized clinical trials

Asian J Psychiatr. 2024 Jan:91:103839. doi: 10.1016/j.ajp.2023.103839. Epub 2023 Nov 24.

Authors

Arman Shafiee¹, Hassan Moltazemi², Mohammad Javad Amini³, Omid Kohandel Gargari³, Farima Safari⁴, Faeze Soltani Abhari⁵, Kyana Jafarabady⁵, Mahmood Bakhtiyari⁶

Affiliations

¹ Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran. Electronic address: [email protected].
² Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
³ Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
⁴ Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
⁶ Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. Electronic address: [email protected].

PMID: 38056138
DOI: 10.1016/j.ajp.2023.103839

Abstract

This updated meta-analysis aims to evaluate the efficacy of adjunctive antidepressants in the treatment of bipolar depression. The antidepressant group exhibited a significant increase in response rate (RR: 1.12; 95 % CI 1.01-1.25; p = 0.04; I2 =55 %). The pooled results demonstrated a significant increase in response rate in the antidepressant group (RR: 1.12 95 % CI 1.01-1.25, p = 0.04; I2 =55 %). Depression score was significantly lower in the antidepressant group (SMD: -0.20 95 % CI -0.31 to -0.09, p < 0.001; I2 =14 %). Egger's regression test and funnel plot inspection did not suggest publication bias. Adjunctive antidepressants appear to enhance response rates and reduce depressive scores in bipolar depression, though potential biases and study heterogeneity warrant future randomized trials on this topic.

Keywords: Antidepressants; Bipolar depression; Bipolar disorder.

Publication types

Meta-Analysis

MeSH terms

Antidepressive Agents / therapeutic use
Bipolar Disorder* / drug therapy
Humans
Randomized Controlled Trials as Topic

Substances

Antidepressive Agents