Section - Quick Takes

05. Treatment Induced Mood Switching in Affective Disorders

Published on April 1, 2022 Expired on April 1, 2024

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Treatment-emergent affective switches (TEAS) driven by antidepressants must be understood in the context of the primary drivers of mood episodes and the mechanisms by which they are produced. Here’s a brief overview of those factors.

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How often do antidepressants make bipolar disorder worse? Opinions abound, so the article title for this Quick Take, “Treatment-Induced Mood Switching in Affective Disorders,” had me immediately interested. I hope you are **too as this issue commonly comes up and can cause so much disagreement.

Hi! Jim Phelps here for the Psychopharmacology Institute. I should warn you that this article by Drs. Tang, Tang, and Leonard does not provide new data to guide your practice. Instead, the authors begin by asking, what causes affective switches in the first place? Perhaps this would shed light on which antidepressants to avoid or which patients are at greater risk, but to understand switching basically means trying to understand the driving forces behind and the mechanisms of mood episodes. So, this article is actually a to or through bipolar etiology and that’s fascinating.

First, genetics. Is bipolar disorder like Huntington’s—too many triplet repeats in

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Learning Objectives:

After completing this activity, the learner will be able to:

Examine adverse drug reactions to psychiatric medications in small and large databases from around the world.
Assess the efficacy of transcranial magnetic stimulation for smoking cessation in a large randomized trial.
Compare the outcomes of multiple studies of initial treatments for major depressive disorder in a network meta-analysis of pharmacotherapy, psychotherapy, and their combination in acute and maintenance treatment.
Evaluate the relative effectiveness of ketamine and placebo when combined with either mindfulness psychotherapy or psychoeducation for the treatment of alcohol use disorder.
Consider the channels through which antidepressants cause manic switches in susceptible individuals.

Original Release Date: April 1, 2022

Review Date: March 1, 2024

Expiration Date: April 1, 2024

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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