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Bipolar disorder in adults: Treating major depression with antidepressants

Authors
William V Bobo, MD, MPH
Richard C Shelton, MD
Section Editor
Paul Keck, MD
Deputy Editor
David Solomon, MD

INTRODUCTION

The use of antidepressants for acute and maintenance treatment of bipolar depression is controversial because of concerns that these drugs are not effective and may harm patients by causing switches from depression to mania as well as rapid cycling [1-3]. Nevertheless, antidepressants (table 1) are the most commonly prescribed drugs for bipolar depression. Studies of bipolar patients in the United States (n = 7760) [4] and Europe (n = 2231) [5] found that an antidepressant had been prescribed for 50 and 81 percent; this may be due in part to the limited efficacy and tolerability of other treatments [6].

This topic reviews the efficacy of antidepressants for patients with bipolar major depression and the risk of these drugs causing a switch in polarity; the risk of rapid cycling is discussed separately. Choosing a medication regimen to treat bipolar major depression, mania, and hypomania is also discussed separately, as is maintenance treatment of bipolar disorder.

(See "Rapid cycling bipolar disorder: Epidemiology, pathogenesis, clinical features, and diagnosis", section on 'Antidepressants'.)

(See "Bipolar disorder in adults: Pharmacotherapy for acute depression".)

(See "Bipolar disorder in adults: Pharmacotherapy for acute mania and hypomania".)

                        

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Literature review current through: Nov 2016. | This topic last updated: Wed Jul 13 00:00:00 GMT 2016.
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