Could Antidepressants Increase Risk of Mania, Bipolar Disorder?

Use of antidepressant medications is associated with increased risk of mania or bipolar disorder among patients with unipolar depression, according to a recent study.

Previous research has shown associations between treatment with certain antidepressants and acute episodes of mania, but whether or not the drugs are the direct cause of this is unclear.
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To further explore this issue, researchers conducted a retrospective cohort study using electronic health records from 21,012 adults with unipolar depression.

Overall, the incidence rate of mania or bipolar disorder was 10.9 per 1000 person-years. Antidepressant treatment was associated with increased incidence of mania and bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Researchers noted that serotonin reuptake inhibitors and venlafaxine were most significantly associated with risk.

“In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder,” they concluded. “These findings highlight the importance of considering risk factors for mania when treating people with depression.”

—Michael Potts

Reference:

Patel R, Reiss P, Shetty H, et al. Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study. BMJ Open. 2015 December 14 [epub ahead of print]. doi:10.1136/bmjopen-2015-008341.