However, nowadays, several types of bipolar disorder are recognized: bipolar I, bipolar II, cyclothymic disorder, mixed features, and rapid-cycling disorder.Symptoms vary among people with bipolar disorder, depending on what type of bipolar disorder they have. Patients treated with an antidepressant (paroxetine, imipramine, or fluoxetine) were more likely to achieve remission than those who were not taking an antidepressant (RR, 1.41; 95% CI, 1.11 to 1.80). Br J Psychiatry. Curr Psychiatry Rep. 2006;8:478-488.7.

London: NICE; 2006. This issue has long been debated, but studies over the past decade have largely put that debate to rest.On the other hand, nearly all experts saw a role for antidepressants in bipolar II disorder. Available for Android and iOS devices. So most of these questions are nearly moot, in my opinion. 2006; 67:18-21.2. Interesting findings resulted from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a national longitudinal public health initiative funded by NIMH.Of the 1469 participants who were symptomatic at study entry, 858 subsequently achieved recovery (58.4%). Course of illness and maintenance treatments for patients with bipolar disorder. Cipriani A, Barbui C, Geddes JR. Am J Psychiatry. 4. To get the best results from an antidepressant: Be patient. 2006; 163:217-224.19. A prospective study of participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Rationale, design, and methods of the systematic treatment enhancement program for bipolar disorder (STEP-BD). On the other hand, most of what we know about treatment comes from studies on bipolar I. Accessed May 29, 2007.6. The available evidence suggested that there was no clear benefit for routinely adding long-term antidepressants to ongoing treatment with lithium. Bauer MS, Wisniewski SR, Marangell LB, et al. Geddes J. Bipolar disorder. Just skip the antidepressants unless you’re backed into them by not getting better on … Early discontinuation following resolution of the acute episode should be con-sidered. This may take the form of a relationship breakdown; physical, sexual, or emotional abuse; money problems; or the death of a close family member or loved one.Symptoms are thought to be due to changes in the balance of some neurotransmitters in the brain, specifically noradrenaline, serotonin, and dopamine.It can be hard to recognize bipolar disorder initially. If an antidepressant is prescribed without a mood stabilizer, it will often catapult the person into a full-on manic state. Talk to your doctor or … The essential feature of bipolar I disorder (BDI) is a clinical course that is defined by the occurrence of 1 or more manic or mixed episodes; the essential feature of bipolar II disorder (BDII) is a clinical course that is defined by the occurrence of 1 or more major depressive episodes accompanied by at least 1 hypomanic episode. Furthermore, in this study, residual depressive or manic symptoms at recovery and proportion of days depressed or anxious in the preceding year were significantly associated with shorter time to depressive recurrence.Unfortunately, we found just one systematic review investigating the effectiveness of long-term use of antidepressants, which did not provide sufficient evidence to assess the ability of antidepressants to prevent relapse of bipolar disorder.The review provided a narrative overview of the studies, because the variety of comparisons did not allow researchers to perform a meta-analysis or to quantify reliable conclusions.

The proper place and the optimal use of antidepressants in treating bipolar depression continues to be an area of great interest and greater controversy with passionate opinions more common than good studies.