Antidepressants are not "Light"

There are several important non-medication approaches to bipolar treatment: sleep regularity is extremely important for most people for example, (sorry, how boring...). But when people look at medication treatments for bipolar disorder, they are often scared by the side effects. Some are even scared by the names, like "lithium".

By contrast, antidepressants just don't seem to strike people as scary. But in a recent interview, Dr. Fred Goodwin, one of the most highly regarded bipolar experts in the world, said that doctors think of antidepressants "as light, easy uncomplicated drugs; and mood stabilizers as heavy drugs that should be reserved for use as a last resort. But in fact, recent data suggest that we may have to reverse that order of preference, or at least put them on an equal plane. "

He is referring here to the risk of antidepressants worsening bipolar disorder, perhaps in a permanent way ("recurrences of bipolar illness even if the offending antidepressant is discontinued"). This potential risk of antidepressants is only rarely mentioned in psychiatric journals, in part because so far it is mostly a guess, a theory, not an established problem. But imagine if it was correct. Twice as many people with bipolar symptoms are taking antidepressants than are taking mood stabilizers, according to a recent Canadian study (Schaffer).

For more information on this controversial risk of antidepressants, see my webpage summary and look at Controversy #2b.