To identify demographic and clinical characteristics of bipolar depressed patients who require antidepressant (AD) augmentation, and to evaluate the short- and long-term effectiveness and safety of this therapeutic strategy.

One hundred twenty-two bipolar depressed patients were consecutively recruited, 71.7% of them received mood stabilizers (MS)/second-generation antipsychotics (SGA) with AD-augmentation and 28.3% did not. Patients were evaluated at baseline, and after 12 weeks and 15 months of treatment.

The AD-augmentation was significantly higher in patients with bipolar II compared with bipolar I diagnosis. Patients with MS/SGA + AD had often a seasonal pattern, depressive polarity onset, depressive index episode with anxious features, a low number of previous psychotic and (hypo)manic episodes and of switch. They had a low irritable premorbid temperament, a low risk of suicide attempts, and a low number of manic symptoms at baseline. After 12 weeks of treatment, 82% of patients receiving ADs improved, 58% responded and 51% remitted, 3.8% had suicidal thoughts or projects, 6.1% had (hypo)manic switch, and 4.1% needed hospitalization. During the following 12 months, 92% of them remitted from index episode, 25.5% did not relapse, and 11% needed hospitalization. Although at the start advantaged, patients with AD-augmentation, compared with those without AD-augmentation, did not significantly differ on any outcome as well on adverse events in the short- and long-term treatment.

Our findings indicate that ADs, combined with MS and/or SGA, are short and long term effective and safe in a specific subgroup for bipolar depressed patients.

确定需要增强抗抑郁药 (AD) 的双相抑郁患者的人口统计学和临床​​特征，并评估这种治疗策略的短期和长期有效性和安全性。

连续招募了 122 名双相抑郁患者，其中 71.7% 接受了情绪稳定剂 (MS)/第二代抗精神病药 (SGA) 和 AD 增强，28.3% 没有接受。在基线、治疗 12 周和 15 个月后对患者进行评估。

与双相 I 诊断相比，双相 II 患者的 AD 增强显着更高。MS/SGA + AD 患者通常具有季节性模式、抑郁极性发作、具有焦虑特征的抑郁指数发作、少量先前的精神病和（轻度）躁狂发作和转换。他们的病前易激惹气质较低，自杀未遂的风险较低，基线时的躁狂症状数量较少。治疗 12 周后，接受 AD 治疗的患者中有 82% 有所改善，58% 有反应，51% 有缓解，3.8% 有自杀念头或计划，6.1% 有（轻）躁狂转换，4.1% 需要住院治疗。在接下来的 12 个月中，92% 的患者从指数发作中缓解，25.5% 的患者没有复发，11% 的患者需要住院治疗。虽然在开始时有优势，但患有 AD 增强的患者，

我们的研究结果表明，AD 与 MS 和/或 SGA 相结合，在双相抑郁患者的特定亚组中是短期和长期有效且安全的。