Letter to the Editor August 28, 2008

Reply to Misdiagnosis of Bipolar II Disorder as Major Depressive Order

David L. Dunner, MD; Michael E. Thase, MD

J Clin Psychiatry 2008;69(3):502-503

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Sir: Dr. Benazzi is quite correct that individuals with bipolardisorder (and especially bipolar II disorder) are more likely tohave recurrence of depressive episodes than patients with majordepression. He is also correct that subjects were entered into thePREVENT study1 on the basis of having depression meeting DSM-IV-TR criteria, and we agree that structured interviewsused to assess whether a patient has bipolar or recurrent majordepression can miss subtle forms of hypomania and wronglyclassify patients as unipolar when they are truly bipolar.However, the acute treatment phase of the PREVENT studytreated subjects with either venlafaxine (75-300 mg) or fluoxetine(20-60 mg).’ ‹

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