Antidepressants Provide No Added Benefit for Patients with Bipolar Disorder

Bipolar Disorder and Antidepressants

Psychiatric researchers at both the University of Colorado at Denver and Health Sciences Center and the University of Colorado at Boulder took part in a $26.8 million, 22-center study across the United States between 1998 and 2005 that looked at medication effectiveness in patients with bipolar disorder.

The study found that treatment of bipolar patients with a mood stabilizer in conjunction with an antidepressant did not provide any benefit and had similar outcomes to treatment with just a mood stabilizer and a placebo sugar pill. Results are published March 28 in the online edition of the New England Journal of Medicine.

Bipolar disorder is also known as manic-depressive illness and affects 5.7 million American adults, or approximately 2.6 percent of the population age 18 and older (data from the National Institute of Mental Health). Those with bipolar disorder suffer from unusual or extreme shifts in mood, energy, and ability to function, often with periods of normal mood in between. Bipolar disorder typically develops in the teen years or young adulthood.

"A significant portion of depressed individuals are depressed because of bipolar disorder, and often misdiagnosed as suffering from major depression," said Dr. Michael Allen, principal investigator of the study at UCDHSC, associate professor of psychiatry, director of Emergency and Consultation Psychiatry, and co-director of the Mood Disorders Program at the UCDHSC School of Medicine. "Bipolar depressed patients have been systematically excluded from studies of antidepressants up to this point, so there has been little information about the benefits. On the other hand, there is evidence that antidepressants can destabilize bipolar patients. This study was done to test whether there was any benefit or risk associated with adding antidepressants to mood stabilizers in bipolar depressed patients. We found that there was no advantage to using antidepressants."

The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study was funded by the National Institutes of Health