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A large federal study revealed that antidepressants that are usually prescribed with mood stabilizers to treat bipolar disorder may not be helpful against their depressive symptoms.

There are around 5.7 million bipolar sufferers in the US that this study narrows the number of already limited treatments for this disorder.

Director of the National Institutes of Mental Health, Dr. Thomas R. Insel, says that bipolar sufferers need a new generation of drugs as the antidepressants are not being helpful. Other experts believe that antidepressants will keep their role in the disease due to the lack of available treatments and because they do alleviate some distressing symptoms when mood stabilizer alone don’t do the trick.

Bipolar disorder is characterized with mood swings, shifts of depression and mania. These symptoms more than often interfere with daily activities, and severe cases carry a risk of suicide.

Most commonly used mood stabilizers are lithium, valproate and carbamazepine with antidepressants being added to control severe depressive swings. Antidepressants carry a risk of triggering a switch to a manic episode.

Food and Drug Administration hasn’t approved any antidepressants for bipolar treatment but it has been estimated that around 50% to 70% of take them.

In the latest study, the researchers decided to check if the common antidepressants, Wellbutrin and Paxil, would enhance the benefits of mood-stabilizer drugs if they would trigger mania.


The study included 366 patients who were randomly assigned to receive one of the two antidepressants or a placebo pill for 26 weeks along with their mood-stabilizers. Along medical treatment, the patients also received psychological and social therapy.

Of the 179 participants who received both mood stabilizer and antidepressant, 23.5% achieved a durable recovery, defined as an eight-week period marked by no more than two depressive or two manic symptoms. 27.3% of patients who took placebo achieved a durable recovery.

There was no sign that Wellbutrin or Paxil could trigger a manic episode.
Director of the bipolar clinic at Massachusetts General Hospital, Dr. Gary Sachs, said that these results should provide guide to how new patients should be treated, but that there is no need for patients doing well on antidepressants to stop taking them.

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I flew into a major BP and first fully recognizable BP episode after being on Cymbalta for less then a month. I am glad it happened, or it could have been many more years before I might have been dianosed, on the negative side, even though only being on Cymbalta for a month, it's taken me almost the same amount of time to get off the drug. I was advised that my type of BP, rapid cycling - could not be helped by using Lithium - it could make it worse. I'm glad I have a good Psychiatrist who knows her pharmaceuticals well :-)
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I participated in an experimental program using Ketamine to treat Bipolar Depression at NIMH in DC in 2011 and it was instantly effective for three days. It was announced May 04 2016 that they had isolated the safe and non addictive metabolite of Ketamine, HNK, which means completely instantly effective antidepressants can now be developed after many years of testing that have no side effects.
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