Prescribing Antidepressants for Bipolar Depression: What Does the Evidence Say?

Individuals with bipolar disorder spend more time depressed than manic or hypomanic, and treating bipolar depression is a clinical challenge. Antidepressant monotherapy is commonly used, despite guidelines advising against this practice. Compelling evidence indicating that these agents are effective treatments for bipolar depression is lacking, but evidence does indicate that these agents may lead to a manic or hypomanic switch in some patients. Clinicians, therefore, should adhere to current guidelines, avoiding antidepressant monotherapy and using antidepressants as adjunctive treatments with caution.

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