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Related Experiment Videos

Antidepressant-induced rapid cycling: another perspective.

Jeffrey A Mattes1

  • 1Psychopharmacology Research Association of Princeton, Princeton, NJ 08540, USA. jmattesmd@msn.com

Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists
|August 23, 2006
PubMed
Summary

Antidepressants may not cause rapid cycling in bipolar patients. Careful monitoring is key, as mood stabilizers can ensure safety when treating depression with antidepressants.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Neuroscience

Background:

  • Depressive symptoms are a primary cause of morbidity in bipolar disorder.
  • Concerns about antidepressant-induced rapid cycling limit antidepressant use in these patients.

Purpose of the Study:

  • To evaluate the validity and prevalence of antidepressant-induced rapid cycling.
  • To clarify the relationship between antidepressant use and rapid cycling in bipolar disorder.

Main Methods:

  • Literature review focusing on antidepressant-induced rapid cycling.
  • Analysis of whether rapid cycling occurs exclusively in patients experiencing mania or hypomania on antidepressants.
  • Assessment of whether observed cycle length shortening is due to antidepressant effects on depression and mania/hypomania.

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Main Results:

  • The concept of antidepressant-induced rapid cycling primarily stems from patients who develop mania or hypomania.
  • Antidepressant-induced alleviation of depression and precipitation of mania/hypomania can explain most observed data.
  • The poorly defined concept of antidepressant-induced rapid cycling may not be necessary to explain these phenomena.

Conclusions:

  • Bipolar patients stabilized on mood stabilizers can safely use antidepressants.
  • If patients do not experience mania or hypomania while on antidepressants, rapid cycling concerns are minimal.
  • This suggests a safer approach to treating depression in bipolar disorder.