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Antidepressants for Bipolar Disorder

The use of traditional antidepressants to treat bipolar depression is considered experimental, and none are FDA-approved for that purpose. There is no research to show that they have any greater benefit than taking a mood stabilizer (such as lithium or Depakote) alone. Many of the existing studies of their efficacy have focussed mainly on people with unipolar rather than bipolar disorder.

Using antidepressant medication alone to treat a depressive episode is not recommended. The drugs may flip a person, particularly a person with bipolar I disorder, into a manic or hypomanic episode. Hypomania is a more subdued version of mania. Using antidepressants alone also may lead to or worsen rapid cycling in some bipolar patients. In rapid cycling, a person has 4 or more distinct episodes of mania/hypomania or depression over a 1-year period. And while they may "recover" more quickly from depression, they may be more prone to experience a relapse or the next phase of illness sooner and more often than people without rapid cycling.

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Nevertheless, there are many different types of antidepressants used to treat depression in people with bipolar disorder. With antidepressants, it typically takes three to four weeks for people to respond to treatment. Sometimes a doctor will try several different medicines before finding one that works for a patient. These medications include SSRIs such as Zoloft or Prozac, SNRIs such as Effexor, and novel antidepressants such as Wellbutrin.

Note: The FDA has determined that antidepressant medications can increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on July 31, 2014

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