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Lookup NU author(s): Professor Heinz Grunze
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The role of stimulants for treating severe depression remains controversial, especially when it comes to bipolar depression. Potential benefits have to be weighed against risks, including addictive potential and treatment-emergent mania. But not all stimulants are the same. Modafinil and its R-enantiomer armodafinil seem to have positive augmentation effects when coupled with standard treatment of bipolar depression, while also having a relative low risk of addiction and manic switches. A recent hypothesis derived from the observation of hypovigilance in manic patients postulates that modafinil may also have a beneficial effect in reducing manic behaviors. Further controlled studies are needed to clarify the benefits and risks of stimulants, both in bipolar depression and mania.
Author(s): Grunze H
Publication type: Review
Publication status: Published
Journal: Harvard Review of Psychiatry
Year: 2014
Volume: 22
Issue: 6
Pages: 358-362
Print publication date: 01/11/2014
Acceptance date: 23/04/2013
ISSN (print): 1067-3229
ISSN (electronic): 1465-7309
Publisher: LIPPINCOTT WILLIAMS & WILKINS
URL: http://dx.doi.org/10.1097/HRP.0000000000000003
DOI: 10.1097/HRP.0000000000000003