Antidepressants for bipolar disorder

The use of antidepressants in the treatment of bipolar disorder remains controversial. Some studies and treatment guidelines suggest that antidepressant treatment for bipolar disorder may have the potential to increase the manic switch, while others recommend short-term antidepressant treatment and early discontinuation.

A recent study by Dr. Yingli Zhang and co-workers from Mental Health Institute of Central South University in China involved new large-sample double-blind randomized controlled trials, excluded open-label design studies, and supplemented studies involving homogeneous patients. Suicidality firstly served as an important outcome, strict inclusion criteria included limitation to double-blind randomized controlled studies and interventional treatment without use of antipsychotics to make the study results more objective and convincing.

The results from this study do not support that antidepressants are more effective in the treatment of bipolar disorder. Antidepressants are not superior to placebo and other medication in short-term, and long-term use of antidepressants cannot achieve higher response and remission rates of bipolar disorder. These findings, published in the Neural Regeneration Research (Vol. 8, No. 31, 2013), guide future clinical studies and provide evidence for preparing treatment strategy for bipolar disorder.