Rapid Fade of Antidepressant Effect of Nefazodone in Bipolar Depression

Letter to the Editor

Sir: The treatment of bipolar depression is problematic. The generally atypical, frequently anergic presentation tends to limit antidepressant choice. Monoamine oxidase inhibitors may be particularly useful in this regard. However, antidepressants have been found to induce a manic switch at a rate that is 5 to 7 times that of spontaneous switch among unmedicated depressed bipolar patients.