Study: Antidepressants Can Worsen Rapid Cycling In Bipolar Depression

Jose Florez

SSRI antidepressants are linked to deteriorating emotional rapid cycling in patients suffering from bipolar disorder, researchers suggest.

According to study published in the Journal of Affective Disorders, psychiatric researchers initiated a randomized study to further certify the "lack of safety" that antidepressants may have on a huge portion of people with bipolar disorder.

Researchers from the University of Louisville, Tufts, Stanford, and the University of Pennsylvania, performed a secondary analysis of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), to better understand the relationship between rapid cycling and antidepressants.

Sixty-eight "clinically recovered" participants with bipolar disorder -- 18 of which were rapid cycling -- were studied for at least two months while taking both an antidepressant and a mood stabilizer.

Thereafter, patients were then randomized into antidepressant continuation or discontinuation groups. All patients, however, maintained a continuous intake of mood stabilizers.

The study concluded that the majority participants who were not in the antidepressant group, had few, if any, depressive episodes. Those with rapid cycling, who were maintained on antidepressants, reported an average of two-to-four depressive episodes.

Researchers stated that long-term maintenance of antidepressants was linked to more mood disorders.

"In this sample, long-term continuation of antidepressants was associated with more mood episodes in patients with rapid-cycling bipolar disorder, particularly with three-fold increased rate of depressive episodes in the first year of follow-up."
"Even with pre-selection for good antidepressant response and absence of acute mania related to antidepressants, and despite concurrent mood stabilizer treatment, a priori analysis of rapid cycling status predicted more depressive episode criteria in those who continued antidepressant treatment as opposed to discontinued antidepressant treatment. This decreased efficacy of antidepressants supports previous claims of limited clinical utility and lack of safety in long term treatment of (bipolar disorder) patients with (antidepressants)."

Data of 216 participants were analyzed by researchers at the University of Michigan Medical School. Participants' sleep qualities -- in conjunction with their mood -- were examined over a period of two years.

The findings of the study, for women, suggests that poor sleep can lead to increased severity and frequency for both depression and full-blown mania.

According to the results, it was concluded that men with bipolar disorder have a personality trait called "neuroticism." This personality trait, only in men, was a much better predictor of mood outcomes than lack of sleep, PsyPost reported.

Curiously, however, researchers have proposed a good reason why poor sleep only has a tenacious effect on women. They believe it could potentially be the result of "biological factors" that may be present during sleep time.

Findings also conclude that women have more persistent depressive episodes than men do. Additionally, women tend to also have coexisting conditions such as anxiety, eating disorders, and migraines.

Bipolar disorder is a chronic mood disorder in which symptoms can range from depressive lows to manic highs. Problems with sleep, like insomnia, is synonymous with individuals suffering from the mood disorder.

[Photo Courtesy: Volkan Olmez/Unsplash]