Classic Study of the month

STEP-BD

A major study demonstrates antidepressant inefficacy in bipolar depression


As discussed in the last PL issue, about a decade ago, three classic NIMH-sponsored studies of clinical treatment were conducted, one each in MDD, bipolar illness, and schizophrenia. The MDD study, called STAR*D,  was reviewed in the last PL issue. The bipolar study was called STEP-BD (Systematic Treatment Evaluation Program for Bipolar Disorder).  

STEP-BD was mostly an observational cohort study, but one large randomized trial was conducted with over 300 subjects to test the  hypothesis whether antidepressants are effective for acute bipolar depression. This was a randomized trial of paroxetine or bupropion versus placebo, added to mood stabilizers for the acute depressive episode. The main result was that...

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