MEDIX, God. 14 Br. 77 Supplement 1  •  Pregledni članak  •  Psihijatrija HR ENG

Antidepresivi u liječenju bipolarnog afektivnog poremećajaAntidepressants in the treatment of bipolar disorder

Bjanka Vuksan-Ćusa

Uporaba antidepresiva u bipolarnom afektivnom poremećaju kontroverzna je tema u psihijatriji. Depresivna faza predominantna je faza raspoloženja za većinu bolesnika s bipolarnim afektivnim poremećajem, često praćena suicidalnim simptomima. Depresivni simptomi češće su razlog traženja liječničke pomoći u odnosu na manične. Pored toga, uzrokuju više dizabiliteta nego bilo koja druga manifestacija bolesti, stoga je uporaba antidepresiva u slučajevima teških, suicidalnih depresija opravdana. Antidepresivi mogu biti povezani s indukcijom manije, destabilizacijom stanja i brzom izmjenom faza. Preporučuje se vremenski ograničena uporaba antidepresiva (selektivnih inhibitora ponovnog unosa serotonina, inhibitora monoaminooksidaze, bupropiona) u kombinaciji sa stabilizatorom raspoloženja

Ključne riječi:
nuspojave lijekova, antidepresivi, bipolarni poremećaj, psihofarmakoterapija, suicidalnost

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 14 Br. 77 Supplement 1

The use of antidepressants in the treatment of bipolar disorder is a controversial issue in psychiatry. Depression is a predominant abnormal mood in bipolar disorder and frequently associated with suicidality. Medical help is sought more often for depressive symptoms than manic symptoms. Depressive symptoms also cause more disability than any other manifestation of the illness. Therefore, the use of antidepressants in cases of severe depression with suicidal ideation is justified. Antidepressants can induce mania and rapid cycling of bipolar disorder. Time-limited use of antidepressants (selective serotonine re-uptake inhibitors, monoaminooxidase inhibitors and bupropion) is recommended in combination with mood stabilisers, particularly in the treatment of patients with serious depression and sucidal tendencies

Key words:
adverse effects, antidepressive agents, bipolar disorder, drug therapy, suicide