Antidepressants May Not Benefit Those With Bipolar Disorder

Antidepressants, which are widely prescribed with mood stabilizers to treat patients with bipolar disorder, do not work in relieving the depressive symptoms of the illness, according to a study published in the New England Journal of Medicine on March 28.

The goal of the study, which was part of the National Institute of Mental Health's $27 million Systematic Treatment Enhancement Program for Bipolar Disorder, or STEP-BD, was to determine whether antidepressants could enhance the benefits of mood stabilizing drugs such as lithium, valproate and carbamazepine.

An additional study goal was to determine if the antidepressants used would trigger mania. Wellbutrin and Paxil were the two antidepressants chosen for the study since previous studies indicated that they were the least likely to trigger mania.

Study participants were randomly selected to receive either one of the two antidepressants or a placebo in addition to a mood stabilizer. Patients also received psychological and social therapy. When the results were analyzed, researchers found that there was no statistically significant difference between the patients who received the antidepressant and those who didn't. They also reported that the antidepressants used did not seem to trigger any manic episodes. Both groups experienced symptoms of mania at about the same rate.

According to lead author, Dr. Gary Sachs, director of the bipolar clinic at Massachusetts General Hospital, the study should guide the way new patients are treated, but, if patients who are currently taking antidepressants are doing well, there is no need for them to quit taking them.