Advertisement

What are disadvantages of antidepressants for bipolar disorder treatment?

John Preston, PsyD
Psychology
It cannot be stressed enough that the use of antidepressants in bipolar I can provoke manic episodes (in psychiatry this effect is known as switching) and can cause increased frequency of manic and depressive episodes (this effect is often referred to as cycle acceleration). In addition, antidepressants are generally ineffective in treating bipolar depression in people with bipolar I. They can be used in bipolar II, but with caution, and only if other treatments have been ineffective. When used, they must be prescribed along with an anti-manic agent (e.g., lithium). Antidepressants can provoke hypomania, but of greater concern is the possibility that long-term antidepressant treatment may cause cycle acceleration in bipolar II patients. Antidepressants are a well-known cause of rapid cycling (e.g., experiencing four or more full-blown episodes a year). Among antidepressants, the monoamine oxidase inhibitors (MAOIs) like Nardil and Parnate have the best track record in terms of effectiveness, although they are rarely used in the United States. Also effective are Wellbutrin and some other antidepressants such as Prozac and Zoloft. All carry some risks of switching, but this is much less likely if given alongside a mood stabilizer. The antidepressant Effexor and older-generation antidepressants like Elavil are very prone to cause rapid cycling and cycle acceleration.

Please note that not all health care professionals are aware of this information. It simply can't be stated often enough that antidepressants in bipolar disorder treatment must be handled by a skilled health care professional who understands these medications' direct effect on bipolar disorder mood swings. It is never indicated for a person with bipolar disorder to be on an antidepressant without some form of anti-mania medication. There are no exceptions. If your loved one is on an antidepressant, it is essential that they discuss this issue with their prescriber.
Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

More About this Book

Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner (The New Harbinger Loving Someone Series)

Maintaining a relationship is hard enough without the added challenges of your partner’s bipolar disorder symptoms. Loving Someone with Bipolar Disorder offers information and step-by-step advice...

Continue Learning about Antidepressant

Are Antidepressants Safe to Take During Pregnancy?
Are Antidepressants Safe to Take During Pregnancy?
Research suggests that depression is diagnosed twice as often in women as it is in men, and it typically presents during a woman’s childbearing years....
Read More
How does Doxepin interact with other medications?
Donna Hill Howes, RNDonna Hill Howes, RN
If you have taken an MAO inhibitor in the past 2 weeks, you should not take doxepin due to possible ...
More Answers
Should I take antidepressants if I smoke?
Dr. Robin Miller, MDDr. Robin Miller, MD
Smokers who take antidepressants often have a lower risk of heart attacks. In this video, Dr. Ro...
More Answers
What Is Treatment-Resistant Depression?
What Is Treatment-Resistant Depression?

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.