Lithium Versus Paroxetine in Patients With Major Depression Who Have a Family History of Bipolar Disorder or Suicide
Status:
Terminated
Trial end date:
2013-01-01
Target enrollment:
Participant gender:
Summary
This study is being done to look at how well people respond to two very different drug
treatments for depression. Clinically, people with depression can respond differently to drug
treatments for reasons which are not always clear. Some of our own recent research suggests
that people with depression who have a family history of bipolar disorder or completed
suicide, may react differently to standard antidepressant medications than those without such
a family history. Our data shows that family history of completed suicide, as well as the
known predictor of family history of bipolar disorder, may help identify a pre-bipolar high
risk group i.e. they currently have depression but at some future date will declare a bipolar
illness (manic-depression) by virtue of development of a manic episode also. Our research
suggests that treatment- emergent symptoms in response to a trial of antidepressant, such as
agitation may be strong predictors of future bipolarity and inherently dangerous particularly
as they are not ascribed to the antidepressant treatment. Finally, it is possible that this
subgroup of those with depressive illness may respond better and more safely to lithium, a
mood stabiliser used in known bipolar depression.
The objective of this proposal is to investigate response to acute lithium treatment in
subjects who meet the diagnostic criteria for major depression, but who are potentially at
risk for bipolar disorder, by virtue of family history of bipolarity or completed suicide.