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Read Original Story

Bipolar Treatment Comes Into Question

Rating

5 Star

Bipolar Treatment Comes Into Question

Our Review Summary

The story reports recent evidence that anti-depressants given in conjunction with mood stabilizing drugs (such as lithium) do not significantly improve depression or exacerbate mania in bipolar patients.   The story suggests that anti-depressants are over-prescribed to patients with bipolar disorder; therefore, there is a suggestion that less treatment with anti-depressants is better. 

The story appropriately describes the design and some of the quantitative results of a randomized, placebo-controlled, double-blind study conducted by The Systemic Treatment Enhancement Program for Bipolar Disorder and published in the New England Journal of Medicine.  The story includes information from an author of the study, as well as from a researcher not involved in the study, but who specializes in bipolar treatment. The story notes that the study was sponsored by the National Institute of Mental Health. 

The story mentions the potential harm of triggering a manic episode and reports (accurately) that there was no observed difference.  The story could have gone further and discussed common harms from antidepressants stacked up against this finding of no benefit – strong incentive to stop giving antidepressant to bipolar disorder. 

The story also could have discussed other options (such as psychosocial treatments) and whether any of these treatments work. 

Overall, though, a very complete story – and in only 406 words.   

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

The story does not mention the cost of medication to treat bipolar disorder; however, the story and evidence from the study cited are advocating fewer anti-depressant medications.   So cost seems less of an issue in this case.  However, the story missed an opportunity to talk about the cost of bipolar disease (90 million work loss days annually in the U.S) and associated health care/treament costs.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story provides some absolute data on patients' self-reported recoveries and mood. At 26 weeks follow-up, of 366 bipolar patients, 27% of patients who took a mood stabilizer and placebo experienced 8 weeks of of positively improved mood, but did not become manic; 23.%5 of patients receiving anti-depressants and a mood stabilizer achieved the same 8-week period of improved mood.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentions the potential harm of triggering a manic episode and reports (accurately) that there was no observed difference in the groups studied. The story could have gone further and discussed common harms from antidepressants stacked up against this finding of no benefit – strong incentive to stop giving antidepressants for bipolar disorder.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story describes the study design and provides some quantitative evidence from the study of bipolar patients who were given placebos or anti-depressant medications with mood stabilizing drugs.

Does the story commit disease-mongering?

Satisfactory

The story does not engage in disease mongering. The story lists the estimated prevalence of bipolar disorder in the U.S.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story includes information from an author of the study cited, as well as from a researcher not involved in the study, but who specializes in bipolar treatment. The story mentions that the study was sponsored by the National Institute of Mental Health, and the authors disclose the potential conflicts.  

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story notes, in passing, that mood stabilizing drugs are used.  It doesn't say anthing about other options (such as psychosocial treatments) and whether any of these treatments work. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

It's clear from the story that the drugs in question are commonly prescribed and available.  

 

Does the story establish the true novelty of the approach?

Satisfactory

The story reports on a recent evidence that anti-depressants given in conjunction with mood stabilizer drugs do not significantly improve depression in bipolar patients.  This was a novel research question and finding. 

 

Does the story appear to rely solely or largely on a news release?

Satisfactory

There was independent reporting and no evidence the information in this story is taken directly from a press release.

Total Score: 8 of 9 Satisfactory

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