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How effective are antidepressants at treating bipolar I disorder?

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Common antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) have not been shown to be as effective for treating depression in bipolar I disorder as in unipolar depression. In a small percentage of people, they can also set off or worsen a manic episode in a person with bipolar disorder. However, studies have shown that for bipolar II depression, some antidepressants (such as Prozac and Zoloft) may be safe and more helpful than in the treatment for bipolar I depression. For these reasons, the first-line treatments for depression in bipolar disorder involve medicines that have been shown to have antidepressant properties but also no known risk for causing or worsening mania. The three FDA-approved treatments for bipolar depression are lurasidone (Latuda), olanzapine-fluoxetine (Symbyax) combination, quetiapine (Seroquel) or quetiapine fumarate (Seroquel XR). Other mood-stabilizing treatments that are sometimes recommended for treating acute bipolar depression include lithium, Depakote, and Lamictal (although none of these latter three medicines is FDA-approved specifically for bipolar depression). If these fail, after a few weeks a traditional antidepressant or other medicine may sometimes be added. Psychotherapy, such as cognitive-behavioral therapy, may also help.

People with bipolar I disorder (mania or depression) have a high risk for recurrences and should take medicines on a continuous basis to prevent them.

From: Bipolar I Disorder WebMD Medical Reference

SOURCES: Moore, D. Mosby, 2004. National Institute of Mental Health web site: "Bipolar Disorder."  Medical News Today: "Study Identifies Predictors Of Bipolar Disorders Risk." WebMD Medical Reference from Healthwise: "Bipolar Disorder -- What Increases Your Risk." Sunovion Pharmaceuticals, Inc.




Handbook of Medical Psychiatry,

Reviewed by Smitha Bhandari on November 08, 2017

SOURCES: Moore, D. Mosby, 2004. National Institute of Mental Health web site: "Bipolar Disorder."  Medical News Today: "Study Identifies Predictors Of Bipolar Disorders Risk." WebMD Medical Reference from Healthwise: "Bipolar Disorder -- What Increases Your Risk." Sunovion Pharmaceuticals, Inc.




Handbook of Medical Psychiatry,

Reviewed by Smitha Bhandari on November 08, 2017

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How is electroconvulsive therapy (ECT) used to treat bipolar I disorder?

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