By Jane Mountain, MD

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A study concluding that the use of standard antidepressants added to mood stabilizers in the treatment of bipolar disorder provided no greater benefit than mood stabilizers plus placebo was published in the New England Journal of Medicine, on March 28, 2007. The study was a smaller study embedded within the largest study on bipolar disorder ever undertaken, the STEP-BD study, sponsored by the National Institute of Mental Health.

Antidepressants have been widely used with a group of medications called mood stabilizers for treatment of bipolar depression in the United States, but the medical community has long questioned their benefit, as well as debating a perceived risk that they trigger a switch from depression to manic episodes. The study concludes that switches of mood states are no more common for patients treated with antidepressants added to mood stabilizers than for those on placebo plus mood stabilizers.

This study is a significant addition to the medical literature about bipolar disorder, and it will stir further discussion in the medical community. However, it may not conclusively answer the question about use of antidepressants in bipolar disorder.

2-3% of the population has bipolar disorder. With the release of this study those in treatment and their doctors will be asking whether antidepressants are a safe and necessary treatment when added to mood stabilizers, which are the primary medications for bipolar disorder.

Individuals with bipolar disorder and their families can see this study as an important addition to our knowledge about bipolar disorder. However, the medical community will need time to debate the issues raised in this study. In the meantime, for those on antidepressants used with mood stabilizers who are experiencing good mental health, they need not discontinue antidepressants and should always make changes in medications with the help of their doctor or prescriber. Jane Mountain, MD, the author of the book, Bipolar Disorder: Insights for Recovery, is an educator and advocate for those with bipolar disorder. She has bipolar disorder herself, and is the director of the Depression/Bipolar Recovery Group of Midtown Denver, a

member of the Honorary Board of the Mental Health Association of Colorado and a contributing editor to the ISBD Global, newsletter of the International Society of Bipolar Disorders.Contact: Jane Mountain, MD – Telephone: 303.329.3364 – Cell: 720.270.9633 – Email: – Fax: 303.329.3094 – Denver, CO, March 28, 2007 –  P. O. Box 300039

Denver, CO   80203-0039

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