Your doctor may prescribe newer antidepressants known as SSRIs (selective serotonin reuptake inhibitors) for treating severe depression in bipolar disorder. They are usually prescribed along with lithium or other antimanic drugs such as valproate, carbamazepine or an atypical antipsychotic.
SSRIs are believed to work by boosting levels of the brain chemical serotonin.
Bipolar disorder is treated with three main classes of medication: mood stabilizers, antipsychotics, and, while their effectiveness for the condition is controversial, antidepressants.
Typically, treatment entails a combination of at least one mood-stabilizing drug and/or atypical antipsychotic, plus psychotherapy. The most widely used drugs for the treatment of bipolar disorder include lithium carbonate and valproic acid (also known as Depakote). Lithium carbonate can be remarkably effective in...
Most antidepressants take several weeks to start working. Though the first one that is prescribed works in the majority of people, others may need to try two or three to find the right one. Your doctor may also prescribe a sedative to help relieve anxiety, agitation, or sleep problems while the antidepressant begins to work.
SSRI Side Effects
SSRI side effects are generally milder than those of the older classes of antidepressants. There are many strategies to counteract the common side effects of SSRIs if they develop, and some side effects may occur only briefly at the beginning of treatment.
Common SSRI side effects may include:
Loss of libido
Weight gain or loss
The FDA recommends close observation of young people treated with SSRIs or other antidepressants for worsening depression or the emergence of suicidal tendencies. It is unclear whether antidepressants contribute to the emergence of suicidal thinking and behavior. However, the FDA indicates a need for careful monitoring of patients being treated with these drugs -- especially at the beginning of therapy and during dose changes.
WebMD Medical Reference: "Bipolar Disorder (Manic Depressive Disorder)."
WebMD Assess Plus: Bipolar Disorder Assessment.
National Institute for Mental Health: "Step-BD Womens Studies."
Massachusetts General Hospital Bipolar Clinic & Research Program.
MedicineNet.com: "Bipolar Disorder (Mania)."
WebMD Medical Reference: "Effects of Untreated Depression."
American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Bipolar Disorder."