Over 10 million people in America suffer from bipolar disorder, according to the National Alliance of Mental Illness. This disorder produces alternating, recurring episodes of mania and depression and usually requires lifelong treatment. Antidepressants can work with mood stabilizers to reduce the symptoms of the depressive phase. Although some may benefit from treatment with antidepressants, bipolar patients should always talk to a doctor about the effectiveness and possible risks before using these medications.
Manic Episodes and Rapid Cycling
Antidepressant medication may trigger manic episodes. They also may increase the likelihood of rapid cycling, causing an increase in the frequency of manic and depressive episodes. Many physicians attempt to treat the depressive phase of bipolar disorder with other treatment options before prescribing antidepressant medications. Individuals using antidepressants to treat the depressive phase of their condition should take caution and report any changes in mood or symptoms to a doctor immediately.
Effectiveness
The National Institute of Mental Health notes that there is currently some debate about whether antidepressant medications are effective at helping people with bipolar depression. Bipolar patients should talk to their doctor about the current research regarding antidepressant effectiveness and explore other options.
Types
Many different classes of antidepressants exist, and each works in a slightly different way. Selective serotonin reuptake inhibitors, or SSRIs, include the medications citalopram, fluvoxamine, fluxetine, escitalopram, paroxetine and sertraline. Serotonin and norepinephrine reuptake inhibitors, or SNRIs, include the medications venlafaxine and duloxetine. Tricyclic and tetracyclic antidepressents include the medications maprotiline, amoxapine, protriptyline, imipramine, trimipramine, nortriptyline, desipramine, amitriptyline and clomipramine. Monoamine oxidase inhibitor medications, or MAOIs, include the medications phenelzine, tranylcypromine and isocarbazid. MAOI medications are generally used as a last resort, as they can produce numerous unpleasant and dangerous side effects. Some antidepressant medications are considered “atypical” because they do not fit into any of the other categories, explains MayoClinic.com. Atypical antidepressants include the medications bupropion, trazodone, mirtazapine and nefazodone.
Side Effects
Antidepressant medications may cause unpleasant side effects. SSRI and SNRI medications may cause sexual dysfunction, sleepiness, insomnia or nausea, but the side effects of these types of antidepressants are generally less severe or potentially dangerous than other types. Tricyclic or tetracyclic antidepressants may cause low blood pressure, weight gain, increased appetite, urinary retention, constipation, dry mouth, dizziness, nervousness, sleepiness, sexual dysfunction and may be toxic if levels in the blood get too high. MAOIs may cause dry mouth, dizziness, urinary retention, low blood pressure, sleep problems, weight gain and sexual dysfunction. They also can cause dangerously high blood pressure and can fatally interact with other medications. Bupropion has the fewest sexual side effects of all antidepressants, according to MayoClinic.com, but can cause dangerous side effects for people with seizure disorders and eating disorders. It also may cause agitation, insomnia, anxiety, dry mouth and headaches. Trazodone and nefazodone may cause constipation, weight gain, constipation, dry mouth, sleepiness, dizziness and nausea. Because nefazodone may cause serious liver damage, it is not prescribed very often.
Withdrawal
Most antidepressants can cause bothersome and potentially dangerous withdrawal effects if stopped too suddenly. People who need to stop taking an antidepressant medication should talk to their doctor about gradually reducing the dosage of their medication. This weaning process can take several months, but it eliminates the risk of these dangerous withdrawal effects.
