Antidepressants worsen depression in patients with rapid-cycling bipolar disorder

Enhanced depression symptoms and suicidal ideation are counter-intuitively well-known side effects of most, if not all, antidepressant drugs. When it comes to bipolar disorder new research suggest caution should be taken in administering currently available antidepressants to clients whose condition is considered to be rapidly-cycling, i.e. they experience at least four episodes within a 12-month period.

The randomized clinical trial found that rapid-cycling patients who continued antidepressants following initial treatment for the episode experienced three times the number of depressive episodes the following year as those who discontinued use of antidepressants. With approximately 25% of bipolar patients considered to rapid-cycling in the US, authors suggest avoiding antidepressant use in these patients as they will probably increase mania, cycling and depression.

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