Mounting evidence of adverse effects of antidepressants in bipolar patients…
According to a study published in the February issue of the American Journal of Psychiatry, patients with bipolar disorder may be at a higher risk for treatment-emergent mania when taking antidepressants. According to the study, even patients with lower scores for bipolar symptoms, such as racing thoughts and psychomotor agitation, were at a higher risk for rapid mood switches when taking antidepressants. This study provides the first prospective controlled data, adding to the already abundant evidence of adverse effects of antidepressants in bipolar patients. The following is an excerpt of an article from Medpage Today that discusses the study further:
These findings are the first prospective, controlled data supporting heightened risk of mood cycling and add to mounting evidence against antidepressants in bipolar disorder, noted Christopher D. Schneck, M.D., of the University of Colorado, in an accompanying editorial.
By re-emphasizing the importance of evaluating these symptoms, he wrote, “clinicians may be able to better predict which patients have an underlying bipolar diathesis and thereby avoid giving them antidepressants.”
But finding effective strategies to treat mixed presentations in bipolar disorder is a challenge, Dr. Frye acknowledged. While there are treatments approved for the manic phase of bipolar disorder, no antidepressants are FDA approved for the depressive phase.
Because treatment-emergent mania events can be “volatile and very destructive for the patient as well as their family,” Dr. Frye said he is now much more alert to risk-associated symptoms and more likely to use alternative treatments, such as mood stabilizers or focused psychotherapy.
The researchers analyzed outcomes for 176 adult outpatients with bipolar disorder in a 10-week trial comparing bupropion (Wellbutrin), sertraline (Zoloft), and venlafaxine (Effexor) as adjunctive antidepressant treatment for depression.