Role Of Antidepressants In Combating Bipolar Disorder

Thousands of people around the world are affected by many different types of mental illnesses. Some are aware of them while others remain unaware of the condition and go through life suffering from symptoms. Bipolar disorder is one such mental condition that is characterized by extreme shifts in a person’s moods. People suffering from bipolar disorder experience bouts of euphoria that can suddenly turn into severe depression. Bipolar disorder is also known as manic depression and bipolar disease as well.

Role Of Antidepressants In Combating Bipolar Disorder

Individuals who have bipolar disorder have trouble managing the everyday tasks in their lives and also have difficulty maintaining healthy relationships. There is no cure for bipolar disorder, but there are many types of treatments available that help you manage the day to day symptoms of the disease. One such treatment method revolves around using traditional antidepressants. While treatment of bipolar disorder with antidepressants is still considered to be experimental, researchers claim to have experienced quite a bit of success through this method of treatment. Let us take a look at the role of antidepressants in combating bipolar disorder.

About Bipolar Disorder & Its Treatment

Bipolar disorder is a mental disease that affects many people around the world. Bipolar disorder is typically characterized by extreme shifts in moods, ranging from episodes of euphoria, followed by episodes of depression. The phase during which a person experiences euphoria is also known as manic episodes. People suffering from bipolar disorder need to get proper treatment and help from a qualified physician. While there is no cure for bipolar disorder, there are many types of treatments available that help you manage the symptoms and effects of bipolar disorder.

Bipolar disorder needs to be treated on an ongoing basis in order to manage the symptoms. It is necessary for patients to keep consulting a mental health professional regularly, even if you feel that you have your symptoms under control. There are many types of treatments that are available today that help you better manage the symptoms of bipolar disorder, allowing you to live a better quality of life. Treatment options include lifestyle changes, counseling and medications. Many people also claim that natural remedies are also helpful.

Coming to medications, many doctors have started using traditional antidepressants to treat bipolar disorder. Though still experimental, the use of antidepressants for treating bipolar disorder is proving to be beneficial for patients.

Are Antidepressants Effective in Treating Bipolar Disorder?

Most medications have proven to be ineffective in the treatment of bipolar disorder, following which, the US Food and Drug Administration (FDA) approved the use of traditional antidepressants for the treatment of bipolar disorder. However, there is no scientific proof or research that shows that taking antidepressants have a greater benefit as compared to taking a mood stabilizer such as Depakote or lithium. This is because most studies looking at the efficiency of antidepressants till date have focused on people suffering from unipolar disorder rather than bipolar disorder.

Using antidepressants along for treating bipolar disorder is not recommended who are suffering from bipolar I disorder. This is because taking only antidepressants as the primary treatment can cause a flip in the patient’s behavior, turning it into a manic or hypomanic episode. Antidepressants, if taken alone, may also cause rapid or worsening cycling of moods in bipolar patients. Rapid cycling refers to having four or more well-defined episodes of depression or mania/hypomania during a year.

One can judge the efficacy of the antidepressant within 4 to 6 weeks. It may take some experimenting with different types of antidepressants before your doctor settles for one that responds best to your bipolar disorder.

What Types of Antidepressants are Used to Treat Bipolar Disorder?

There are many types of antidepressants that are used in the treatment of bipolar disorder. Different antidepressants include:

  • SSRIs or serotonin-reuptake inhibitors
  • SNRIs or serotonin-norepinephrine reuptake inhibitors
  • MAOIs or monoamine oxidase inhibitors
  • Tricyclics

As mentioned above, antidepressants should not be prescribed by themselves, as they may trigger manic episodes in bipolar disorder. This is why antidepressants are generally prescribed along with a mood stabilizer drug to control any manic symptoms of bipolar disorder.

What are the Common Antidepressants Used for Combating Bipolar Disorder?

Let us take a look at the commonly prescribed antidepressants for bipolar disorder.

Serotonin-Reuptake Inhibitors (SSRIs)

  • Celexa (citalopram)
  • Lexapro (escitalopram)
  • Prozac, Prozac Weekly (fluoxetine)
  • Paxil, Paxil CR, Pexeva (paroxetine)
  • Zoloft (sertraline)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

  • Pristiq (desvenlafaxine)
  • Cymbalta, Yentreve (duloxetine)
  • Effexor (venlafaxine)

Monoamine Oxidase Inhibitors (MAOIs)

  • Nardil (phenelzine)
  • Parnate (tranylcypromine)
  • Tricyclic Antidepressants
  • Norpramin (desipramine)
  • Tofranil, Tofranil-PM (imipramine)
  • Pamelor (nortriptyline)
  • amitriptyline

MAOIs are not commonly prescribed. These are only given when a patient does not respond well to SSRIs or SNRIs. If you have been prescribed an MAOI, then there will be several precautions that need to be followed, the most important one being that you have to avoid taking any other medications along with it. You will also need to avoid foods like cheese and also wine. If you do not follow the precautions with MAOIs then it can lead to a dangerous condition known as serotonin syndrome.

What are the Side Effects of Prescribing Antidepressants for Bipolar Disorder?

There are several side effects associated with taking antidepressants for treating bipolar disorder. Some of the common side effects include:

It is important to understand that according to the FDA, antidepressant drugs are known to increase the risk of suicidal thinking in adolescents and children with depression as well as other psychiatric disorders. Always inform your doctor if you experience any of the side effects or if you begin to have suicidal thoughts.

Conclusion

You should only take antidepressants for bipolar disorder after consulting your doctor and only if your doctor prescribes them for your condition. Antidepressants should always be used with a mood stabilizer and preferably psychotherapy as well to be most effective in combating bipolar disorder. Remember that it takes some time for these antidepressants to enter your bloodstream and start working, so have patience. It may take a couple of days to a couple of weeks for you to start feeling the effects of the antidepressants in combating bipolar disorder.

If you experience any of the side effects of antidepressants or any problems, always speak to your doctor about it. If you experience any severe side effects, then it could mean that antidepressants are not working for you and you need to be put on another treatment plan. Do not skip the doses of your antidepressants and also stick to the recommended dosage. Do not stop taking your antidepressants without asking your doctor.

Since there is no cure for bipolar disorder, you will need to follow a treatment plan to manage your symptoms to live a better quality of life. Make sure to inform your doctor about any other underlying conditions or medications you are on before you begin the antidepressant treatment plan for bipolar disorder treatment.

Also Read:

References

  1. Courtet, P., Samalin, L. and Olié, E., 2011. Antidepressants in bipolar disorder. L’Encephale, 37, pp.S196-202.
  2. Cascade, E.F., Reites, J., Kalali, A.H. and Ghaemi, N., 2007. Antidepressants in bipolar disorder. Psychiatry (Edgmont), 4(3), p.56.
  3. Ghaemi, S.N., Hsu, D.J., Soldani, F. and Goodwin, F.K., 2003. Antidepressants in bipolar disorder: the case for caution. Bipolar disorders, 5(6), pp.421-433.
  4. Zhang, Y., Yang, H., Yang, S., Liang, W., Dai, P., Wang, C. and Zhang, Y., Antidepressants for bipolar disorder.
  5. Salvi, V., Fagiolini, A., Swartz, H.A., Maina, G. and Frank, E., 2008. The use of antidepressants in bipolar disorder. The Journal of clinical psychiatry, 69(8), pp.1307-1318.

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