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    Evaluation of Antidepressant Choices for The Treatment of Depressive Symptoms in Patients with Bipolar Disorder
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Atagun, Murat Ilhan; Altinbas, Kursat; Yesilyurt, Sema; Yesilbas, Dilek; Guloksuz, Sinan; Oral, Timucin
    Objective: Antidepressants are thought to cause manic switches and accelerate cycling in the treatment of bipolar depression. On the other hand, other evidence suggests that antidepressant neither cause manic switches, nor are effective for the treatment of bipolar depression. This study aimed to assess clinicians' attitudes towards antidepressant choices for treatment of bipolar depressive episodes and subthreshold depression. Methods: Medical records of 784 patients with bipolar disorder were investigated retrospectively. Antidepressants were used in 55 of 263 depressive episodes (20.9%). Data regarding 78 episodes (23 subthreshold symptoms, 55 episodes) of 68 patients (54 female, 14 male; mean age: 39.64 +/- 10.99) were obtained. Descriptive statistics were the evaluation method. Results: In our department, antidepressants were used in 20.9% of the patients in the treatment of bipolar depression. One third of patients receiving antidepressant prescriptions had a history of manic switch, 5 (21.7%) of the patients with subthreshold symptoms receiving antidepressant prescriptions had a history of manic switch. However, manic switch occurred in only 5 (6.4%) patients. Selective serotonin reuptake inhibitors were the most common cause (58.3%) of the manic switch in patients with a history of manic switch. Discussion: Clinicians are still using antidepressants in the treatment of bipolar depression. Antidepressants targeting many neurotransmitter systems can be used in the first line treatments and antidepressants can be used even in patients with a history of manic switch. This controversial topic should be studied prospectively with larger samples and it must be clarified whether this phenomenon is a natural course of the disorder or triggered by antidepressant medications.
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    LIFETIME HYPOMANIC SYMPTOMS IN REMITTED PATIENTS WITH SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
    (Medicinska Naklada, 2014) Altinbas, Kursat; Yesilyurt, Sema; Aras, Hatice Imer; Smith, Daniel J.; Craddock, Nick
    Background: Clinical, genetic and neuroimaging studies indicated strong evidence against traditional diagnostic separation of bipolar disorder from schizophrenia. In this study, we aimed to evaluate hypomanic symptoms and influence on general functioning among psychotic patients. Subjects and methods: Patients with schizophrenia and other psychotic disorders were assessed between June and September 2010. Positive and Negative Symptom Scale (PANSS), Hypomania Check List-32 (HCL-32), Mood Disorders Questionnaire (MDQ) and General Assessment of Functioning Scale (GAS) were applied to all 93 patients. Answers of self-rating scales were confirmed with hospital records. Results: Mean age was 35.7 +/- 9.5 years, mean age of onset was 20.3 +/- 5.3 years and duration of illness was 15.4 +/- 9.2 years. 30.1% of the patients, had a history of mood stabilizer treatment taken at least one month while one five of the patients had different psychiatric diagnosis other than current diagnosis. 26.9% of the patients with psychotic disorders had positive scores on both MDQ and HCL-32 but there were no significant difference between patients in terms of general functioning (p=0.82). Conclusions: As reported in this study, there is no simple, clear-cut between schizophrenia and bipolar affective disorder.