Antidepressants are drugs that are used to treat disorders like major depressive disorders, anxiety disorder, eating disorders, sleep disorder and many others. Mood disorders like bipolar disease are also treated by antidepressant. Bipolar disorder consists of episodes with mood swings that range from depressive lows to manic highs.

According to Rif S. El-Mallakh, M.D., director of the Mood Disorders Clinical and Research Program at the University of Louisville, along with Nassir Ghaemi, M.D., of Tufts University and other researchers, antidepressants can increase the incidents of depression and mood cycling in bipolar disease. A clinical trial was conducted for this research on modern antidepressants.

Trial

Patients that have bipolar disease were tracked. The patients started on antidepressants and then after a year, half of the patients stopped taking them while the other half continued.

“They 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. RC patients who continued antidepressants were episode-free 52 percent of the time, while RC patients who discontinued antidepressants were episode-free 64 percent of the time.”

Results

The results were published in Journal of Affective Disorders in the September issue. The patients in the study were classified as either rapid cycling or non-rapid cycling. Both of the groups received standard mood stabilizers.

“Whether or not antidepressants cause rapid cycling in BD is a controversial issue,” the authors said in the article. “Antidepressants are the most commonly prescribed class of medication in BD. If they cause or worsen rapid cycling, found in about 25 percent of patients with BD, this presents a major public health problem. Safely and effectively treating rather than exacerbating mood episodes in the most severely ill among this patient population is a priority.”

There have been other studies that concluded antidepressants for patients with bipolar disease have been detrimental. In 2011 article Medical Hypothesis, patients using antidepressants to treat depression have improved initially, but later on they worsened. This concluded that antidepressants lose their effectiveness in long-term usage.

El-Mallakh, professor of psychiatry in the UofL School of Medicine, says, “Antidepressants are useful medications, and you don’t know if someone will be rapid cycling when you begin treating them. However, if someone has rapid cycling, you want to avoid using these drugs because the medication will probably increase mania, cycling and depression.”