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Related Experiment Videos

Which antidepressants flick the switch?

Gordon Parker1, Kay Parker

  • 1School of Psychiatry, University of New South Wales, and Mood Dis-orders Unit, Black Dog Institute, Randwick 2031, Australia. g.parker@unsw.edu.au

The Australian and New Zealand Journal of Psychiatry
|July 23, 2003
PubMed
Summary
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Antidepressants can induce manic switching in depressed patients. While older drugs pose a risk for bipolar depression, newer antidepressants appear safer, allowing confident prescription without mood stabilizers.

Area of Science:

  • Psychiatry
  • Pharmacology

Background:

  • Mood disorders require careful management.
  • Antidepressant-induced manic switching is a clinical concern.

Purpose of the Study:

  • To review the risk of manic switching with antidepressant drugs.
  • To evaluate new antidepressant classes for this risk.

Main Methods:

  • Literature review of relevant studies.

Main Results:

  • Unclear risk of switching with antidepressants in unipolar depression.
  • Tricyclic and MAOI drugs increase switching risk in bipolar depression.
  • SSRIs do not appear to increase switching risk at standard doses.
  • Dual-action antidepressants have an unestablished, possibly slight, switching risk.

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Conclusions:

  • Narrow-acting antidepressants show minimal causal risk for switching.
  • Clinicians can prescribe certain antidepressants for bipolar depression confidently.
  • Mood stabilizers are not necessarily required to prevent switching.