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Can teens take antidepressants for bipolar disorder?

Dr. Michael Roizen, MD
Internal Medicine

Yes, and they can be incredibly helpful. However, they are used with extreme caution in children because of the risk of suicidal thoughts. The risk increases when antidepressants are first taken or when a dosage is increased. Your child’s doctor will know which medications will be the safest and most effective treatment options for your child.

 

Monitor your child for behavior changes such as irritability or problems sleeping. Report any changes in behavior early and repeatedly to your child’s doctor.


John Preston, PsyD
Psychology
The use of antidepressants in the treatment of bipolar disorder is fraught with problems. There is general agreement that antidepressants can result in a number of adverse outcomes including triggering manic episodes, over a period of time, increasing the frequency and duration of bipolar episodes, and increasing irritability. Additionally, for most people suffering from bipolar disorder, antidepressants simply are not effective. The type of depression seen in bipolar disorder is significantly different than the more common, unipolar depression (where antidepressants can be effective treatments).

The risks of manic episodes are only seen in bipolar I (people with bipolar II do not experience mania). In all professional practice guidelines, antidepressants are not recommended for treating bipolar I. However, there is some controversy when it comes to treating bipolar II disorder. As noted, with bipolar II manias do not occur. However, the most common problem is simply that antidepressants generally do not work. It is not entirely clear, but there is concern that antidepressant use in bipolar II may cause cycle acceleration (a term that means an increase in frequency and severity of episodes over a period of time). Having said this, there are some people who suffer from bipolar II who may benefit from antidepressants, if all other approaches have failed (i.e. this absolutely is not a first-line treatment). Additionally, if antidepressants are used this must be in combination with a mood stabilizer (e.g. lithium or Depakote) or antipsychotic medication.

The use (inappropriate use) of antidepressants in treating bipolar disorder (bipolar depression) is a very common and often serious error in the treatment of this mood disorder.

There may be even greater concerns about the use of antidepressants in teenagers. Adolescents may be more prone to having suicidal ideas become more intense if given antidepressants alone.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.