Related Experiment Video
Updated: Jun 16, 2026

Developing a Rat Model for Bipolar Disorder
Published on: May 2, 2025
Antidepressant-induced mania with concomitant mood stabilizer in patients with comorbid substance abuse and bipolar
Daniel Z Lieberman1, George Kolodner, Suena H Massey
1Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Ave., NW, Washington, DC 20037, USA. dlieberman@mfa.gwu.edu
Abstract:
Antidepressant use in the treatment of bipolar disorder is controversial due the risks of affective switching and cycle acceleration. Studies of non-comorbid samples suggest that the risk can be mitigated with the use of a concomitant mood stabilizer. However, the majority of patients with bipolar disorder will experience a comorbid substance use disorder and little is known about these individuals because they are typically excluded from clinical trials. Patients entering a substance abuse treatment program who had a history of bipolar disorder were interviewed to evaluate antidepressant-induced affective switching with and without concomitant mood stabilizer. Among 41 comorbid participants, the total lifetime antidepressant-induced switch rate was 76%. The switch rate was 56% for patients taking a mood stabilizer and an antidepressant concomitantly. There was no difference between patients with bipolar I and bipolar II disorders.
Related Concept Videos
Mania and Antimanic Drugs: Overview
Bipolar Disorder
Antidepressant Drugs: MAOIs and Other Agents
Drug Therapy
Antianxiety Medications
Psychosis and Antipsychotic Drugs: Overview
Psychosis: Goals of Pharmacotherapy