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Tricyclic Antidepressants for Bipolar Disorder

Older tricyclic antidepressants used for treating bipolar disorder may be more likely to trigger a manic episode or rapid cycling than other depression drugs. They also tend to have more side effects than newer generation antidepressants, and can be especially dangerous in overdose.  However, they are occasionally still used when other antidepressants are not effective, or when certain other conditions (such as migraine or neuropathic pain disorders) are also present.  Like all antidepressants, experts recommend against taking a tricyclic medication without a mood stabilizer (such as lithium or divalproex) to minimize the chance of inducing mania symptoms.

Tricyclic antidepressants include:

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Bipolar I Disorder

Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood and high energy, accompanied by abnormal behavior that disrupts life. Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression...

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Tricyclic antidepressants work by increasing levels of the mood chemicals serotonin and norepinephrine in the brain. However, because they may sometimes increase the risk of mania or rapid cycling -- as well as heart problems if you take heart medication -- these drugs are less often recommended for bipolar disorder.

 

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on October 18, 2014

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