Prospective Observation of Switching Rate of Antidepressants in Management of Depressive Episode in 3 Months


Objective: to observe prospectively of switching rate of antidepressants in management of depressive episode. Methods: 190 patients with depressive episode treated by antidepressants were observed for 3 months and switching rate were assessed under “best natural therapy”. And switching criteria was following: 1) manic or hypomanic episode; or 2) promoting rapid cycling; or 3) YMRS ≥ 11 or irritability or aggravation in YMRS ≥ 3. 4) Psychiatrist thinks that the patients should be stopped to take antidepressants and should be placed by mood stabilizer or antipsychotics or their combination. Results: 1) 18 of 190 patients was found to switch in 3 month therapy. The switching rate was 9.47%. 2) 4 of 61 males was found and 14 females was found to switch, their switching rate was not significant (6.56%, 10.85%, X2 = 0.89, P > 0.05). 3) 10 of 170 unipolar depression and 8 of bipolar depression was found to switch, their switching rate was very significant (5.88%, 40%, X2 = 24.29, P < 0.01). 4) 5 of 36 patients token mood stabilizer and 13 patients not token mood stabilizer was found to switch, their switching rate was not significant (13.8%, 8.44%, X2 = 1.47, P > 0.05). 5) 7 of 54 patients token more two antidepressants and 11 patients token single antidepressant was found to switch, their switching rate was not significant (12.96%, 8.08%, X2 = 1.07, P > 0.05). 6) 7 of 38 patients with family history of mood disorder and 11 of patients without family history of mood disorder was found to switch, their switching rate was significant (18.4%, 7.23%, X2 = 4.43, P < 0.05). 7) The switching often carried out at one month after treatment with antidepressants. 8) The significant difference in switching rate among various antidepressants were not found. Conclusion: Some depressive patients may switch during treatment with antidepressant, it should be stressed on.

Share and Cite:

Jin, W. , Wang, N. , Ma, Y. & Tong, Z. (2013). Prospective Observation of Switching Rate of Antidepressants in Management of Depressive Episode in 3 Months. Psychology, 4, 174-177. doi: 10.4236/psych.2013.43026.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Akiskal, H. S. (1996). The prevalent clinical spectrum of bipolar disorders: Beyond DSM-IV. Journal of Clinical Psychopharmacology, 16, 4s-14s.
[2] Barak, Y., Kimhi, R., & Weizman, R. (2000). Is selectivity for serotonin uptake associated with a reduced emergence of manic episodes in depressed patients? International Clinical Psychopharmacology, 15, 53-56. doi:10.1097/00004850-200015010-00009
[3] Bottlender, R., Rudolf, D., Strauss, A. et al. (2001). Mood stabilizers reduce the risk of developing antidepressant-induced maniform state in acute treatment of bipolar I depressed patients. Journal of Affective Disorders, 63, 79-83. doi:10.1016/S0165-0327(00)00172-5
[4] Chun, B. J., & Dunner, D. L. (2004). A review of antidepressant-induced hypomania in major depression: Suggestions for DSM-V. Bipolar Disorders, 6, 32-42. doi:10.1046/j.1399-5618.2003.00084.x
[5] Ferrier, I. N., Macmillan, I. C., & Yong, A. H. (2011). The search for the wadering thymostat: A rewiew of some developments in bipolar research. The British Journal of Psychiatry, 178, s103-s106.
[6] Gao, K., Kemp, D. E., Ganocy, S. J. et al. (2008). Treatment-emergent mania/hypomania during antidepressant monotherapy in patients with rapid cycling bipolar disorder. Bipolar Disorders, 10, 907-915. doi:10.1111/j.1399-5618.2008.00637.x
[7] Ghaemi, S. N., Ko, J. Y., & Goodwin, F. K. (2002). Cade’s disease and beyond: Misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder. Canadian Journal of Psychiatry, 47, 125-134.
[8] Jin, W. D. (2007). Antidepressants and switching (in Chinese). Journal of Clinical Psychology in Medical Settings, 17, 209-221.
[9] Jin, W. D., Chen, J., Xing, B. P., et al. (2007a). Antidepressants and switching (in Chinese). Joural of Clinical Psychology in Medical Setting, 17, 209-221.
[10] Jin, W. D., Chen, J., Xing B. P. et al. (2005). Clinical epidemiological survey of switching induced by antidepressants. Switching rate and it’s difference in different type of depression (in Chinese). Journal of Pharmacology Epidenmiology, 14, 217-219.
[11] Jin, W. D., Chen, J., Xing, B. P. et al. (2007b). Establishment and evaluation of advising criteria of soft bipolar disorder (in Chinese). Chinese Journal of Behavioral Medical Science, 16, 801-803.
[12] Jin, W. D., Tang, X. X., Wang, H. Q. et al. (2006). Meta-analysis of the difference in clinical symptomatology between Bipolar and Unipolar depression (in Chinese). Chinese General Practice, 9, 401-403.
[13] Jin, X. G., & Jin, W. D. (2007). Lithium carbonate can decrease switching associated with antidepressants: Meta-analysis of domestic data. Shanghai Arch Psychiatry, 19, 313-314.
[14] Peet, M. (1994). Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. The British Journal of Psychiatry, 164, 549-550. doi:10.1192/bjp.164.4.549
[15] Rousseva, A., Henry, C., van den Bulke, D. et al. (2003). Antidepressant-induced mania, rapid cycling and the serotonin transporter gene polymorphism. The Pharmacogenomics Journal, 3, 101-104. doi:10.1038/sj.tpj.6500156
[16] Song, Z. X., Xu, L. P., Jin, W. D. et al. (2008). Retrospective study on switching rate of different antidepressants in the treatment of bipolar depression (in Chinese). Journal of Psychiatry, 21, 9-13.
[17] Tondo, L., Vázquez, G., & Baldessarini, R. J. (2010). Mania associated with antidepressant treatment: Comprehensive meta-analytic review. Acta Psychiatrica Scandinavica, 121, 404-414. doi:10.1111/j.1600-0447.2009.01514.x

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.