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Major depression with hypomanic symptoms (“mixed depression” in the DSM-5) is associated with poorer antidepressant response, more psychiatric and medical comorbidities, and family history of bipolar illness. To learn more about antidepressant response in such patients, researchers conducted a secondary analysis of the randomized CO-MED study of 665 depressed patients, which found similar response rates overall to escitalopram, extended-release venlafaxine plus mirtazapine, or sustained-release escitalopram plus bupropion.
About half of participants had at least one hypomanic symptom on the five-item Altman Self-Rating Mania Scale. Mixed-depression patients were more likely to be black and non-Hispanic and had more psychiatric and medical co…