Short-term venlafaxine v. lithium monotherapy for bipolar type II major depressive episodes: Effectiveness and mood conversion rate
Open accessAbstract
Background: Controversy exists over antidepressant use in bipolar II depression. Aims: To compare the safety and effectiveness of antidepressant v. mood stabiliser monotherapy for bipolar type II major depressive episodes. Method: Randomised, double-blind, parallel-group, 12-week comparison of venlafaxine (n = 65) v. lithium (n = 64) monotherapy in adult out-patients (trial registration number NCT00602537). Results: Primary outcome – venlafaxine produced a greater response rate (67.7%) v. lithium (34.4%, P<0.001). Secondary outcomes – venlafaxine produced a greater remission rate (58.5% v. 28.1%, P<0.001); greater decline in depression symptom scores over time (β=–5.32, s.e. = 1.16, χ 2 = 21.19, P<0.001); greater reduction in global severity scores over time (β=–1.05, s.e. = 0.22, χ 2 = 22.33, P<0.001); and greater improvement in global change scores (β=–1.31, s.e. = 0.32, χ 2 = 16.95, P<0.001) relative to lithium. No statistically significant or clinically meaningful differences in hypomanic symptoms were observed between treatments. Conclusions: These findings suggest that short-term venlafaxine monotherapy may provide effective antidepressant treatment for bipolar II depression without a statistically significant increase in hypomanic symptoms relative to lithium.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In three placebo-controlled RCTs conducted in the 1970s and 1980s, lithium decreased the frequency and/or severity of hypomanic and depressive episodes.
“In three placebo‐controlled RCTs conducted in the 1970s and 1980s (duration = 11‐25 months), lithium decreased the frequency and/or severity of hypomanic and depressive episodes.399, 450, 452”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [450]
The Discussion and Limitations and future directions sections describe this paper’s short-term venlafaxine-versus-lithium study, which had no placebo comparison group. A search for historical placebo-controlled lithium trials and maintenance outcomes found no passage reporting three trials from the 1970s and 1980s or their claimed reductions in hypomanic and depressive episodes. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 29 · Cited by 52
Research works printed but not linked: 8
- [12]12. Amsterdam JD, Wang C-H, Schwarz M, Shults J. Initial therapy of rapid and non-rapid cycling patients with bipolar II major depressive episode. J Affect Disord 2009; 112: 219-30.
- [13]13. Amsterdam JD, Wang G, Shults J. Venlafaxine monotherapy of bipolar II major depressive episode in non-responders to prior lithium monotherapy: a cross-over study. Acta Psychiatrica Scand 2010; 121: 201-8.
- [16]16. Williams JBW. A structured interview guide for the Hamilton Depression Rating Scale. Arch Gen Psychiat 1988; 45: 742-7.
- [17]17. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition with Psychotic Screen (SCID-I/P W/PSY SCREEN). Biometrics Research, New York State Psychiatric Institute, 2001.
- [21]21. Leverich GS, Altshuler LL, Frye MA, Suppes T, McElroy SL, Keck PE Jr, et al. Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am J Psychiatry 2006; 163: 232-9.
- [22]22. Sachs GS, Nierenberg AA, Calabrese JR, Marangell LB, Wisniewski SR, Gyulai L, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med 2007; 356: 1711-22.
- [27]27. Amsterdam JD, Garcia-Espan ˜a F, Schweizer E, Fawcett J, Quitkin FM, Reimherr FW, et al. Fluoxetine and bipolar II major depressive episode. J Clin Psychopharmacol 1998; 18: 435-40.
- [29]29. Amsterdam JD. Efficacy and safety of venlafaxine in bipolar type-II and unipolar major depressive disorder. J Clin Psychopharmacol 1998; 18: 414-7.
- Authors
- Amsterdam, J. D., Lorenzo-Luaces, L., Soeller, I., Li, S. Q., Mao, J. J., & DeRubeis, R. J.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Amsterdam, Jay D.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-04
- Volume
- 208
- Issue
- 4
- Pages
- 359-365
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC4816972
- OpenAlex
- W2287449015
- Cited by
- 52
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 6
- FWCI
- 7.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pennsylvania
- National Institutes of Health
- National Institute of Mental Health (MH 060353, R01MH080097, R01MH060353, MH080097)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- venlafaxine, lithium, bipolar II disorder, major depressive episode, antidepressant monotherapy, treatment response and remission
- MeSH terms
- Venlafaxine Hydrochloride, Adolescent, Adult, Aged, Antidepressive Agents, Bipolar Disorder, Double-Blind Method, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Treatment Outcome, Lithium Compounds, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
