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.
Original language | English (US) |
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Pages (from-to) | 348-355 |
Number of pages | 8 |
Journal | Journal of Addictive Diseases |
Volume | 28 |
Issue number | 4 |
DOIs | |
State | Published - Oct 2009 |
Keywords
- Affective switching
- Antidepressant-induced mania
- Bipolar II
- Bipolar depression
- Bipolar disorder
- Substance use disorder
ASJC Scopus subject areas
- Psychiatry and Mental health
- Clinical Psychology
- Medicine (miscellaneous)