Induction of mania and cycle acceleration in bipolar disorder: effect of different classes of antidepressant.
OBJECTIVE
To assess the effect of different antidepressants on induction of mania and cycle acceleration, commonly accepted unwanted effects of antidepressant treatment for acute bipolar depression. There is, however, the suggestion that certain classes of antidepressants may be less likely than others to cause these unwanted effects.


METHODS
We conducted a prospective, open, naturalistic, life charting study to assess the occurrence of onset of mania and cycle acceleration attributable to two antidepressant classes: selective serotonin reuptake inhibitors (SSRIs) and bupropion.


RESULTS
No difference was found between the two drug classes for either antidepressant-induced mania or cycle acceleration. Antidepressant-induced mania was much more likely to occur in bipolar I rather than bipolar II patients. The overall occurrence of induction of mania and cycle acceleration was low across antidepressant classes.


CONCLUSIONS
These findings suggest that there is probably no difference in the risk of antidepressant-induced mania or cycle acceleration across commonly used classes of antidepressants for the treatment of bipolar depression.
Joffe
R T
RT
Regional Mood Disorders Program, Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada. joffe@umdnj.edu
MacQueen
G M
GM
Marriott
M
M
Robb
J
J
Begin
H
H
Young
L T
LT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000145:classification* / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010507:Periodicity
D000928:Antidepressive Agents