Antidepressants in bipolar depression: An enduring controversy
Open accessAbstract
The proper place and the optimal use of antidepressants in treating bipolar depression continues to be an area of great interest and greater controversy with passionate opinions more common than good studies. Even the handful of meta-analyses in the area disagree with each other. Overall, the evidence that antidepressants are effective in treating bipolar depression is weak. Additionally, many experts and clinicians worry greatly about the capacity of antidepressants to cause affective switching or mood destabilization. Yet, in short term controlled studies, with most patients also taking mood stabilizers, antidepressants are not associated with switches into mania/hypomania. Evidence of cycle acceleration with antidepressants primarily reflects treatment with older antidepressants, e.g., tricyclics. Similar evidence with modern antidepressants such as selective serotonin reuptake inhibitors (SSRIs) is lacking. The key questions should not be: are antidepressants effective in bipolar depression?; And: do antidepressants worsen the course of bipolar disorder? Rather, the question should be focused on subgroups: for which patients are antidepressants helpful and safe, and for which patients will they be harmful? Predictors of affective switching with antidepressants include: bipolar I disorder (vs. bipolar II), mixed features during depression, tricyclics vs. modern antidepressants, rapid cycling and possibly a history of drug abuse, especially stimulant abuse. Additionally, a number of recent studies have demonstrated both the safety and efficacy of antidepressant monotherapy in treating bipolar II depression. Finally, a subgroup of bipolar individuals need antidepressants in addition to mood stabilizers as part of an optimal maintenance treatment regimen.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Prescription of antidepressants to bipolar patients is controversial and could worsen the clinical picture.
“Also, treatment between these illnesses differs substantially and prescription of antidepressants to bipolar patients is controversial and could worsen the clinical picture [70].”
From Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers (2021) · cites this paper as [70]
Treatment differs substantially between bipolar and unipolar depression.
“Also, treatment between these illnesses differs substantially and prescription of antidepressants to bipolar patients is controversial and could worsen the clinical picture [70].”
From Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers (2021) · cites this paper as [70]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Davenport, Y. B., Adland, M. L., Gold, P. W., & Goodwin, F. K. (1984) · The Lancet · doi:10.1016/s0140-6736(84)92810-1 · Cited by 2,925 · see citing works
Judd, L. L., Akiskal, H. S., Schettler, P. J., Coryell, W., Endicott, J., Maser, J. D., Solomon, D. A., Leon, A. C., & Keller, M. B. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.3.261 · Cited by 1,243 · see citing works
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M., O’Donovan, C., MacQUEEN, G. M., McIntyre, R. S., Sharma, V., et al. (2012) · Bipolar Disorders · doi:10.1111/bdi.12025 · Cited by 1,209 · see citing works
Effectiveness of Adjunctive Antidepressant Treatment for Bipolar Depression
Sachs, G. S., Nierenberg, A. A., Calabrese, J. R., Marangell, L. B., Wisniewski, S. R., Gyulai, L., Friedman, E. S., Bowden, C. L., Fossey, M. D., Ostacher, M. J., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa064135 · Cited by 937 · see citing works
Tohen, M., Vieta, E., Calabrese, J., Ketter, T. A., Sachs, G., Bowden, C., Mitchell, P. B., Centorrino, F., Risser, R., Baker, R. W., et al. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.11.1079 · Cited by 908 · see citing works
Pacchiarotti, I., Bond, D. J., Baldessarini, R. J., Nolen, W. A., Grunze, H., Licht, R. W., Post, R. M., Berk, M., Goodwin, G. M., Sachs, G. S., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13020185 · Cited by 770 · see citing works
Antidepressant-induced mania and cycle acceleration: a controversy revisited
Altshuler, L. L., Post, R. M., Leverich, G. S., Mikalauskas, K., ROSOFF, A. S., & Ackerman, L. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.8.1130 · Cited by 607 · see citing works
Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled Trials
Gijsman, H. J., Geddes, J. R., Rendell, J. M., Nolen, W. A., & Goodwin, G. M. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.9.1537 · Cited by 563 · see citing works
Goodwin, F. K., & Jamison, K. R. (2007) · Cited by 536 · see citing works
Tohen, M. F., Frank, E., Bowden, C. L., Colom, F., Ghaemi, S. N., Yatham, L. N., Malhi, G. S., Calabrese, J. R., Nolen, W. A., Vieta, E., et al. (2009) · Bipolar Disorders · doi:10.1111/j.1399-5618.2009.00726.x · Cited by 513 · see citing works
Induction of Mania with Selective Serotonin Re-uptake Inhibitors and Tricyclic Antidepressants
Peet, M. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.4.549 · Cited by 476 · see citing works
Course of the Manic-Depressive Cycle and Changes Caused by Treatments
Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (2008) · Pharmacopsychiatry · doi:10.1055/s-2007-1019628 · Cited by 436 · see citing works
Rapid Cycling in Manic-Depressives Induced by Tricyclic Antidepressants
Wehr, T. A. (1979) · Archives of General Psychiatry · doi:10.1001/archpsyc.1979.01780050065007 · Cited by 408 · see citing works
Tranylcypromine versus imipramine in anergic bipolar depression
(1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.7.910 · Cited by 360 · see citing works
Rapid cycling affective disorder: contributing factors and treatment responses in 51 patients
Wehr, T. A., Sack, D. A., Rosenthal, N. E., & Cowdry, R. W. (1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.2.179 · Cited by 356 · see citing works
Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline
Post, R. M., Altshuler, L. L., Leverich, G. S., Frye, M. A., Nolen, W. A., Kupka, R. W., Suppes, T., McElroy, S., Keck, P. E., Denicoff, K. D., et al. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.bp.105.013045 · Cited by 350 · see citing works
Loebel, A. D., Cucchiaro, J. B., Silva, R., Kroger, H., Hsu, J., Sarma, K., & Sachs, G. S. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13070984 · Cited by 340 · see citing works
McElroy, S. L., Weisler, R. H., Chang, W., Olausson, B., Paulsson, B., Brecher, M., Agambaram, V., Merideth, C., Nordenhem, A., Young, A. H., et al. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04942gre · Cited by 328 · see citing works
Fernandes, P., Ramaswamy, S., Marcil, W., & Petty, F. (2007) · xPharm: The Comprehensive Pharmacology Reference · doi:10.1016/b978-008055232-3.60649-x · Cited by 294 · see citing works
Loebel, A., Cucchiaro, J., Silva, R., Kroger, H., Sarma, K., Xu, J., & Calabrese, J. R. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13070985 · Cited by 293 · see citing works
Altshuler, L., Suppes, T., Black, D., Nolen, W. A., Keck, P. E., Frye, M. A., McElroy, S., Kupka, R., Grunze, H., Walden, J., et al. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.7.1252 · Cited by 287 · see citing works
Patterns of Psychotropic Drug Prescription for U.S. Patients With Diagnoses of Bipolar Disorders
Baldessarini, R. J., Leahy, L., Arcona, S., Gause, D. O., Zhang, W., & Hennen, J. A. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.1.85 · Cited by 279 · see citing works
Casper, R. C. (1985) · Archives of General Psychiatry · doi:10.1001/archpsyc.1985.01790340082012 · Cited by 279 · see citing works
Mania associated with antidepressant treatment: comprehensive meta‐analytic review
Tondo, L., Vázquez, G., & Baldessarini, R. J. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01514.x · Cited by 256 · see citing works
The Long-term Course of Rapid-Cycling Bipolar Disorder
Coryell, W. H., Solomon, D., Turvey, C., Keller, M. B., Leon, A. C., Endicott, J., Schettler, P. J., Judd, L. L., & Mueller, T. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.9.914 · Cited by 251 · see citing works
Thase, M. E., Jonas, A., Khan, A., Bowden, C. L., Wu, X., McQuade, R. D., Carson, W. H., Marcus, R. N., & Owen, R. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181618eb4 · Cited by 251 · see citing works
Viktorin, A., Lichtenstein, P., Thase, M. E., Larsson, H., Lundholm, C., Magnusson, P. K. E., & Landén, M. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2014.13111501 · Cited by 246 · see citing works
Vieta, E., Martínez‐Arán, A., Goikolea, J. M., Torrent, C., Colom, F., Benabarre, A., & Reinares, M. (2002) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v63n0607 · Cited by 227 · see citing works
The Prospective Course of Rapid-Cycling Bipolar Disorder: Findings From the STEP-BD
Schneck, C. D., Miklowitz, D. J., Miyahara, S., Araga, M., Wisniewski, S. R., Gyulai, L., Allen, M. H., Thase, M. E., & Sachs, G. S. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.05081484 · Cited by 180 · see citing works
Premenstrual Dysphonias: Myths and Realities
Altshuler, L. L. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.5.804 · Cited by 169 · see citing works
Amsterdam, J. D., & Shults, J. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09020284 · Cited by 149 · see citing works
McGirr, A., Vöhringer, P. A., Ghaemi, S. N., Lam, R. W., & Yatham, L. N. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30264-4 · Cited by 149 · see citing works
Antidepressant Discontinuation in Bipolar Depression
Ghaemi, S. N., Ostacher, M. J., El‐Mallakh, R. S., Borrelli, D. J., Baldassano, C. F., Kelley, M. E., Filkowski, M. M., Hennen, J. A., Sachs, G. S., Goodwin, F. K., et al. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04909gre · Cited by 148 · see citing works
Morbidity in 303 first‐episode bipolar I disorder patients
Baldessarini, R. J., Salvatore, P., Khalsa, H.-M. K., Gebre‐Medhin, P., Imaz, H., González-Pinto, A. M., Pérez, J., Cruz, N., Maggini, C., & Tohen, M. F. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00812.x · Cited by 127 · see citing works
Altshuler, L. L., Kiriakos, L., Calcagno, J. L., Goodman, R., Gitlin, M. J., Frye, M. A., & Mintz, J. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0807 · Cited by 127 · see citing works
Self-citationDurgam, S., Earley, W., Guo, H., Li, D., Németh, G., Laszlovszky, I., Fava, M., & Montgomery, S. A. (2016) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.15m10070 · Cited by 125 · see citing works
Bond, D. J., Lam, R. W., & Yatham, L. N. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.11.008 · Cited by 122 · see citing works
Licht, R. W., Gijsman, H. J., Nolen, W. A., & Angst, J. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01237.x · Cited by 118 · see citing works
Rapid Cycling in Bipolar Disorder
Carvalho, A. F., Dimellis, D., Gonda, X., Vieta, E., McIntyre, R. S., & Fountoulakis, K. Ν. (2014) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13r08905 · Cited by 116 · see citing works
Sachs, G. S., Ice, K. S., Chappell, P. B., Schwartz, J. H., Gurtovaya, O., Vanderburg, D. G., & Kasuba, B. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05934 · Cited by 101 · see citing works
Ronald Bottlender, A., Rudolf, D., Strauß, A., & Möller, H. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00172-5 · Cited by 96 · see citing works
Overview of antidepressant treatment of bipolar depression
Vázquez, G. H., Tondo, L., Undurraga, J. P., & Baldessarini, R. J. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000023 · Cited by 93 · see citing works
Sanford, M., & Keating, G. M. (2012) · CNS Drugs · doi:10.2165/11203840-000000000-00000 · Cited by 78 · see citing works
Liu, B., Zhang, Y., Fang, H., Liu, J., Liu, T., & Li, L. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.07.023 · Cited by 72 · see citing works
Altshuler, L. L., Sugar, C. A., McElroy, S. L., Calimlim, B., Gitlin, M., Keck, P. E., Aquino-Elias, A., Martens, B. E., Fischer, E. G., English, T. L., et al. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15040558 · Cited by 68 · see citing works
Self-citationAntidepressant monotherapy for bipolar type II major depression
Amsterdam, J. D., & Brunswick, D. J. (2003) · Bipolar Disorders · doi:10.1046/j.1399-5618.2003.00066.x · Cited by 58 · see citing works
Vázquez, G. H., Tondo, L., & Baldessarini, R. J. (2010) · Pharmacopsychiatry · doi:10.1055/s-0030-1265198 · Cited by 57 · see citing works
Amsterdam, J. D., Lorenzo-Luaces, L., Soeller, I., Li, S. Q., Mao, J. J., & DeRubeis, R. J. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.05.070 · Cited by 57 · see citing works
An update on antidepressant use in bipolar depression
Sidor, M. M., & MacQueen, G. M. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0323-6 · Cited by 57 · see citing works
Amsterdam, J. D., Lorenzo-Luaces, L., Soeller, I., Li, S. Q., Mao, J. J., & DeRubeis, R. J. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.115.169375 · Cited by 52 · see citing works
One‐year outcome with antidepressant – treatment of bipolar depression
Joffe, R. T., MacQUEEN, G. M., MARRIOTT, M. J., & Young, L. T. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00583.x · Cited by 46 · see citing works
Grande, I., de Arce, R., Jiménez‐Arriero, M. Á., Lorenzo, F. G. I., Valverde, J. I. F., Balanzá‐Martínez, V., Domingo, S. Z., Cobaleda, S., & Vieta, E. (2012) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145712000405 · Cited by 42 · see citing works
Amsterdam, J. D., Luo, L., & Justine Shults, A. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.104711 · Cited by 39 · see citing works
Avoiding Drug-Induced Switching in Patients with Bipolar Depression
Henry, C., & Demotes‐Mainard, J. (2003) · Drug Safety · doi:10.2165/00002018-200326050-00003 · Cited by 37 · see citing works
Amsterdam, J. D., Wang, G., & Justine Shults, A. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01462.x · Cited by 36 · see citing works
Do antidepressants influence mood patterns? A naturalistic study in bipolar disorder
Bauer, M., Rasgon, N., Grof, P., Glenn, T., Lapp, M., Marsh, W., MUNOZ, R. A., Suwalska, A., Baethge, C., Bschor, T., et al. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2006.04.009 · Cited by 29 · see citing works
Pikalov, A., Tsai, J., Mao, Y., Silva, R., Cucchiaro, J. B., & Loebel, A. D. (2017) · International Journal of Bipolar Disorders · doi:10.1186/s40345-017-0075-7 · Cited by 29 · see citing works
Bartoli, F., Dell’Osso, B. M., Crocamo, C., Fiorillo, A., Ketter, T. A., Suppes, T. M., Clerici, M., & Carrà, G. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.12.021 · Cited by 22 · see citing works
Antidepressants in Type II Versus Type I Bipolar Depression
Vöhringer, P. A., Ostacher, M. J., El‐Mallakh, R. S., Holtzman, N. S., Thommi, S. B., Whitham, E. A., Sullivan, M. C., Baldassano, C. F., Goodwin, F. K., Baldessarini, R. J., et al. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000384 · Cited by 18 · see citing works
Antidepressants in bipolar depression: Much confusion, many questions, few answers
Gitlin, M. J. (2012) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412440893 · Cited by 12 · see citing works
Self-citationRajagopalan, K., Bacci, E. D., Wyrwich, K. W., Pikalov, A., & Loebel, A. D. (2016) · International Journal of Bipolar Disorders · doi:10.1186/s40345-016-0049-1 · Cited by 9 · see citing works
Clinician’s Guide to Bipolar Disorder
Kahn, D. A. (2015) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000094 · Cited by 6 · see citing works
Clinical models for managing Bipolar II disorder: model 1
Parker, G. B. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9781139003315.018 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Diagnosis and Treatment of Bipolar Disorder
Nierenberg, A. A., Agustini, B., Köhler‐Forsberg, O., Cusin, C., Katz, D., Sylvia, L. G., Peters, A. T., & Berk, M. (2023) · JAMA · doi:10.1001/jama.2023.18588 · Cited by 424 · see citing works
Bipolar depression: a major unsolved challenge
Baldessarini, R. J., Vázquez, G. H., & Tondo, L. (2020) · International Journal of Bipolar Disorders · doi:10.1186/s40345-019-0160-1 · Cited by 235 · see citing works
Premenstrual Exacerbations of Mood Disorders: Findings and Knowledge Gaps
Kuehner, C., & Nayman, S. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-021-01286-0 · Cited by 93 · see citing works
Dionisie, V., Filip, G. A., Manea, M. C., Movileanu, R. C., Moisa, E., Manea, M., Riga, S., & Ciobanu, A. M. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10091924 · Cited by 82 · see citing works
Patterns of pharmacotherapy for bipolar disorder: A GBC survey
Singh, B., Yocum, A. K., Strawbridge, R., Burdick, K. E., Millett, C. E., Peters, A. T., Sperry, S. H., Fico, G., Vieta, E., Verdolini, N., et al. (2023) · Bipolar Disorders · doi:10.1111/bdi.13366 · Cited by 79 · see citing works
A mechanistic account of serotonin’s impact on mood
Michely, J., Eldar, E., Martin, I. M., & Dolan, R. J. (2020) · Nature Communications · doi:10.1038/s41467-020-16090-2 · Cited by 72 · see citing works
Clinical decision support for bipolar depression using large language models
Perlis, R. H., Goldberg, J. F., Ostacher, M. J., & Schneck, C. D. (2024) · Neuropsychopharmacology · doi:10.1038/s41386-024-01841-2 · Cited by 70 · see citing works
Pires, P. C., Paiva‐Santos, A. C., & Veiga, F. (2023) · Pharmaceuticals · doi:10.3390/ph16101424 · Cited by 59 · see citing works
Bipolar depression: a review of treatment options
Levenberg, K., & Cordner, Z. A. (2022) · General Psychiatry · doi:10.1136/gpsych-2022-100760 · Cited by 59 · see citing works
Review of Allopregnanolone Agonist Therapy for the Treatment of Depressive Disorders
Walkerly, A., Leader, L. D., Cooke, E., & VandenBerg, A. (2021) · Drug Design Development and Therapy · doi:10.2147/dddt.s240856 · Cited by 49 · see citing works
Brain stimulation treatment for bipolar disorder
Mutz, J. (2022) · Bipolar Disorders · doi:10.1111/bdi.13283 · Cited by 47 · see citing works
Drug repositioning for psychiatric and neurological disorders through a network medicine approach
Dias, T. L., Schuch, V., Beltrão-Braga, P. C. B., Martins‐de‐Souza, D., Brentani, H., Franco, G. R., & Nakaya, H. I. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-0827-5 · Cited by 42 · see citing works
The existential crisis of bipolar II disorder
Gitlin, M. J., & Malhi, G. S. (2020) · International Journal of Bipolar Disorders · doi:10.1186/s40345-019-0175-7 · Cited by 39 · see citing works
Self-citationBartoli, F., Cavaleri, D., Bachi, B., Moretti, F., Riboldi, I., Crocamo, C., & Carrà, G. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.09.018 · Cited by 39 · see citing works
Bohlken, J., Bauer, M., & Kostev, K. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112965 · Cited by 35 · see citing works
Barbuti, M., Menculini, G., Verdolini, N., Pacchiarotti, I., Kotzalidis, G. D., Tortorella, A. A. V., Vieta, E., & Perugi, G. (2023) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2023.04.013 · Cited by 34 · see citing works
Lin, Y., Mojtabai, R., Goes, F. S., & Zandi, P. P. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.07.063 · Cited by 33 · see citing works
Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder
Hett, D., & Marwaha, S. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320973790 · Cited by 32 · see citing works
Tundo, A., Betrò, S., de Filippis, R., Marchetti, F., Nacca, D., Necci, R., & Iommi, M. (2023) · Life · doi:10.3390/life13041043 · Cited by 30 · see citing works
McGowan, N. M., Kim, D. S., Crespo, M. D. A., Bisdounis, L., Kyle, S. D., & Saunders, K. E. A. (2022) · CNS Drugs · doi:10.1007/s40263-022-00911-7 · Cited by 29 · see citing works
DellaCrosse, M., Pleet, M., Morton, E., Ashtari, A., Sakai, K., Woolley, J., & Michalak, E. (2022) · PLOS ONE · doi:10.1371/journal.pone.0279073 · Cited by 28 · see citing works
Ketamine for bipolar depression: an updated systematic review
Fancy, F., Haikazian, S., Johnson, D. E., Chen-Li, D. C. J., Levinta, A., Husain, M. I., Mansur, R. B., & Rosenblat, J. D. (2023) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253231202723 · Cited by 29 · see citing works
Montano, C. B., Jackson, W., Vanacore, D., & Weisler, R. H. (2023) · Postgraduate Medicine · doi:10.1080/00325481.2023.2189868 · Cited by 24 · see citing works
An update on potential pharmacotherapies for cognitive impairment in bipolar disorder
Johnson, D. E., McIntyre, R. S., Mansur, R. B., & Rosenblat, J. D. (2023) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2023.2194488 · Cited by 22 · see citing works
Comorbid Premenstrual Dysphoric Disorder in Women with Bipolar Disorder: Management Challenges
Sepede, G., Brunetti, M., & Giannantonio, M. D. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s202881 · Cited by 21 · see citing works
Jain, R., Kong, A. M., Gillard, P. J., & Harrington, A. (2022) · Advances in Therapy · doi:10.1007/s12325-022-02112-6 · Cited by 23 · see citing works
Evaluating the efficacy and safety of antidepressants in patients with bipolar disorder
Cheniaux, E., & Nardi, A. E. (2019) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2019.1651291 · Cited by 21 · see citing works
Pilhatsch, M., Stamm, T. J., Stahl, P., Lewitzka, U., Berghöfer, A., Sauer, C., Gitlin, M. J., Frye, M. A., Whybrow, P. C., & Bauer, M. (2019) · International Journal of Bipolar Disorders · doi:10.1186/s40345-019-0155-y · Cited by 20 · see citing works
Self-citationDepression and anxiety management in cirrhosis
Zimbrean, P. C., & Jakab, S. (2024) · Hepatology Communications · doi:10.1097/hc9.0000000000000600 · Cited by 18 · see citing works
Ghafori, S. S., Yousefi, Z., Bakhtiari, E., hasani, M. H. M. M., & Hassanzadeh, G. (2024) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2024.100734 · Cited by 23 · see citing works
Diagnostic conversion from unipolar to bipolar affective disorder–A population-based study
Jo, Y. T., Joo, S. W., Kim, H., Ahn, S., Choi, Y. J., Choi, W., Park, S. Y., & Lee, J. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.01.082 · Cited by 17 · see citing works
Quetiapine in the Anxiety Dimension of Mood Disorders
Crapanzano, C., Damiani, S., & Guiot, C. (2021) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001420 · Cited by 15 · see citing works
Park, J. H., Núñez, N. A., Gardea‐Resendez, M., Gerberi, D., Breitinger, S. A., Veldić, M., Frye, M. A., & Singh, B. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4433 · Cited by 15 · see citing works
Therapeutic Application of Lithium in Bipolar Disorders: A Brief Review
Kamal, Z. M., Dutta, S., Rahman, S., Etando, A., Hasan, E., Nahar, S. N., Fakuradzi, W. F. S. W. A., Sinha, S., Haque, M., & Ahmad, R. (2022) · Cureus · doi:10.7759/cureus.29332 · Cited by 13 · see citing works
Buoli, M., Cesana, B. M., Maina, G., Conca, A., Fagiolini, A. M., Steardo, L., Altamura, A. C., Dell’Osso, B. M., & on behalf of the ISBD Italian Chapter Epidemiologic Group (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2019.09.001 · Cited by 14 · see citing works
Olgiati, P., & Serretti, A. (2023) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000479 · Cited by 12 · see citing works
Status of Type II vs. Type I Bipolar Disorder: Systematic Review with Meta-Analyses
Hernandorena, C. V., Baldessarini, R. J., Tondo, L., & Vázquez, G. H. (2023) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000371 · Cited by 12 · see citing works
Bui, T. A., O’Croinin, B. R., Dennett, L., Winship, I. R., & Greenshaw, A. J. (2025) · Microbiology · doi:10.1099/mic.0.001568 · Cited by 14 · see citing works
Real-world clinical predictors of manic/hypomanic episodes among outpatients with bipolar disorder
Tokumitsu, K., Yasui‐Furukori, N., Adachi, N., Kubota, Y., Watanabe, Y., Miki, K., Azekawa, T., Edagawa, K., Katsumoto, E., Hongo, S., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0262129 · Cited by 12 · see citing works
Bartoli, F., Malhi, G. S., & Carrà, G. (2024) · International Journal of Bipolar Disorders · doi:10.1186/s40345-024-00336-9 · Cited by 11 · see citing works
Brown, E. S., McArdle, M., Palka, J. M., Bice, C., Ivleva, E. I., Nakamura, A., McNutt, M., Patel, Z., Holmes, T., & Tipton, S. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.12.006 · Cited by 11 · see citing works
Advancements in Valproate Therapy for Seizures, Migraines, and Bipolar Disorders
Bairy, L. K., & Madhyastha, S. (2025) · Medical Principles and Practice · doi:10.1159/000543555 · Cited by 11 · see citing works
Repple, J., Bayas, M., Möser, C., Kobayashi, N. F., & Reif, A. (2025) · Biological Psychiatry · doi:10.1016/j.biopsych.2025.02.903 · Cited by 10 · see citing works
Global Trends in the Use of Pharmacotherapy for the Treatment of Bipolar Disorder
Yocum, A. K., & Singh, B. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01606-8 · Cited by 13 · see citing works
Bohlken, J., Riedel-Heller, S. G., Bauer, M., & Kostev, K. (2021) · Pharmacopsychiatry · doi:10.1055/a-1348-1523 · Cited by 10 · see citing works
Cuomo, A., Pardossi, S., Barillà, G., Carmellini, P., Firenzuoli, B., Tarantino, F., Tinturini, R., & Fagiolini, A. M. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.01.059 · Cited by 9 · see citing works
Brancati, G. E., Barbuti, M., Calderone, A., Fierabracci, P., Salvetti, G., Weiss, F., Santini, F., & Perugi, G. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01306-1 · Cited by 9 · see citing works
Wang, X. B., Luo, J., Yuan, X., Chen, X., Yu, H., Zhu, X., & Wang, G. (2022) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2022.103086 · Cited by 9 · see citing works
Health disparities in the treatment of bipolar disorder
Tchikrizov, V., Ladner, M. E., Caples, F. V., Morris, M., Spillers, H., Jordan, C. D., Balls‐Berry, J. E., Taylor-Desir, M. J., Frye, M. A., & Vallender, E. J. (2023) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2023.100101 · Cited by 8 · see citing works
Jacob, L., Bohlken, J., & Kostev, K. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.02.004 · Cited by 8 · see citing works
Köhler‐Forsberg, O., Sloth, K. H., Sylvia, L. G., Thase, M. E., Calabrese, J. R., Tohen, M. F., Bowden, C. L., McInnis, M. G., Kocsis, J. H., Friedman, E. S., et al. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114194 · Cited by 8 · see citing works
Montano, C. B., Jackson, W. C., Vanacore, D., & Weisler, R. H. (2022) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s337703 · Cited by 8 · see citing works
Kriner, P., Brieger, P., Pogarell, O. M., Schüle, C., Mußmann, L., Korbmacher, J. M., & Seemüller, F. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1425549 · Cited by 8 · see citing works
Vieta, E., McIntyre, R. S., Yu, J., Aronin, L. C., Kramer, K., & Nguyen, H. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.119 · Cited by 7 · see citing works
Park, J. H., Fernando, K., Park, Y. H., & Park, E. O. (2024) · BJPsych Open · doi:10.1192/bjo.2024.27 · Cited by 7 · see citing works
Steger, C., Birckhead, B., Raghunath, S., Straub, J., Sthapit, S., Albert, M. C., Goes, F. S., & Zandi, P. P. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.006 · Cited by 6 · see citing works
Clinical experience with parenteral trazodone in mood disorders: A literature review
Crapanzano, C., Casolaro, I., & Krupa, A. J. (2024) · Psychiatria Polska · doi:10.12740/pp/182933 · Cited by 6 · see citing works
Perspectives on Precision Psychiatry Using Antipsychotics in the Management of Bipolar Disorder
Fornaro, M., Miola, A., Berardis, D. D., Squassina, A., Manchia, M., & Solmi, M. (2025) · Brain Sciences · doi:10.3390/brainsci15050430 · Cited by 6 · see citing works
Bartoli, F., Cavaleri, D., & Crocamo, C. (2025) · ALPHA PSYCHIATRY · doi:10.31083/ap44494 · Cited by 6 · see citing works
Seifert, J., Bleich, S., & Seifert, R. (2022) · Springer eBooks · doi:10.1007/978-3-662-66303-5_22 · Cited by 5 · see citing works
Unmet Needs in Psychiatry: Bipolar Depression
Baldessarini, R. J., Tondo, L., & Vázquez, G. H. (2020) · Springer eBooks · doi:10.1007/978-3-030-42637-8_4 · Cited by 5 · see citing works
Clinical practice guidelines for the management of bipolar disorder: 2025 update
Menon, V., Ganesh, R., Deep, R., Sarkhel, S., Goswami, S., Mohapatra, D., Munoli, R. N., Sharma, P., Reddy, M., & Muralidharan, K. (2026) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry_1186_25 · Cited by 5 · see citing works
Addressing the unmet needs of bipolar disorder in Australia and beyond
Cotton, S., Hasty, M. K., Mitchell, P. B., Murray, G., Hickie, I. B., McGorry, P. D., Walder, K. R., Dean, O. M., Mihalopoulos, C., Yung, A. R., et al. (2025) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674251361727 · Cited by 5 · see citing works
Novák, T., Kostýlková, L., Bareš, M., Renková, V., Hejzlar, M., Renka, J., Baumann, S., Laskov, O., & Klírová, M. (2024) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2024.2357110 · Cited by 4 · see citing works
Moderie, C., Nuñez, N., Comai, S., Saint-Laurent, M., Fielding, A., Low, N., & Gobbi, G. (2022) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001500 · Cited by 4 · see citing works
Addressing depressive disorders among people with HIV.
Fuenmayor, A., & Cournos, F. (2022) · PubMed Central · Cited by 4 · see citing works
Fredskild, M. U., Bruun, C. F., Vinberg, M., Faurholt‐Jepsen, M., Kessing, L. V., & Munkholm, K. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.125 · Cited by 4 · see citing works
Lithium heute — ein Update seiner Wirksamkeit und Risiken
Müller-Oerlinghausen, B. (2019) · NeuroTransmitter · doi:10.1007/s15016-019-6601-3 · Cited by 3 · see citing works
Knowledge Augmentation for Early Depression Detection
Kulkarni, H., MacAvaney, S., Goharian, N., & Frieder, O. (2023) · Studies in computational intelligence · doi:10.1007/978-3-031-36938-4_14 · Cited by 3 · see citing works
Feng, L., Wang, W., Yin, C., Li, J., Zhang, X., Chang, X., Feng, Z., Zandt, M. V., You, S. C., Seager, S. L., et al. (2025) · Health Data Science · doi:10.34133/hds.0209 · Cited by 2 · see citing works
Seifert, J., Bleich, S., & Seifert, R. (2025) · Springer eBooks · doi:10.1007/978-3-662-70594-0_22 · Cited by 2 · see citing works
Zhang, Y. L., Yao, M., Li, H., Wang, Y., Hao, S., Pan, G., Xu, H., Han, X., Zhou, G., Shao, L., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119920 · Cited by 2 · see citing works
Rigas, C., Lavín, P., Chen, P., Torres-Platas, S. G., Su, C., Eyler, L. T., Olagunju, A. T., Teixeira, A. L., Dols, A., Alda, M., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120704 · Cited by 2 · see citing works
Tonini, E., Crouse, J. J., Shin, M., Carpenter, J. S., Mitchell, B. L., Byrne, E. M., Lind, P. A., Gordon, S. D., Parker, R., Hockey, S. J., et al. (2026) · The British Journal of Psychiatry · doi:10.1192/bjp.2026.10798 · Cited by 2 · see citing works
Randomized Controlled Trials and the Efficacy of Psychotropic Medications
Dunlop, B. W., & Ribeiro, C. M. D. F. (2022) · Springer eBooks · doi:10.1007/978-3-030-62059-2_4 · Cited by 2 · see citing works
Varela, R. B., Boschen, S. L., Yates, N. J., Houghton, T., Blaha, C. D., Lee, K. H., Bennet, K. E., Kouzani, A. Z., Berk, M., Quevedo, J., et al. (2024) · Bipolar Disorders · doi:10.1111/bdi.13423 · Cited by 2 · see citing works
Ratheesh, A., Speed, M. S., Salagre, E., Berk, M., Rohde, C., & Østergaard, S. D. (2024) · Bipolar Disorders · doi:10.1111/bdi.13432 · Cited by 2 · see citing works
Affective Disorders, Pharmacogenomics, and Psychiatric Illness-Related Cardiometabolic Problems
Kalin, N. H. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20240428 · Cited by 2 · see citing works
Choi, K. (2022) · Psychiatry Investigation · doi:10.30773/pi.2022.0113 · Cited by 2 · see citing works
Fakhri, A., Asadi, K., Pakseresht, S., Norouzi, S., & Rostami, H. (2023) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_1258_22 · Cited by 1 · see citing works
Drug utilization study of mood stabilizers and antipsychotics drugs among bipolar disorder patients
Lolita, L., & Johan, I. M. (2024) · BIO Web of Conferences · doi:10.1051/bioconf/202414801011 · Cited by 1 · see citing works
Kessing, L. V. (2025) · Danish Medical Journal · doi:10.61409/a07250539 · Cited by 1 · see citing works
Yoo, K. H., Lee, K. J., Lee, S. M., Han, C., Park, R. W., & Jo, Y. T. (2025) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2025.2600083 · Cited by 1 · see citing works
Talukder, A., Kougianou, I., O’Hare, K., Healy, C., & Kelleher, I. (2025) · BMJ Mental Health · doi:10.1136/bmjment-2025-302146 · Cited by 1 · see citing works
Osei-Bonsu, G. A., Dimick, M. K., Kennedy, K. G., Barton, J. S., Sultan, A. A., Young, L. T., Andreazza, A. C., & Goldstein, B. I. (2026) · Journal of Child and Adolescent Psychopharmacology · doi:10.1177/10445463251413071 · Cited by 1 · see citing works
Kong, X., Cao, L., Han, X., Dong, P., & Chen, X. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1750892 · Cited by 1 · see citing works
Bokhari, S. A., Elnour, A. O., & Elnoor, M. (2026) · International Journal of Bipolar Disorders · doi:10.1186/s40345-026-00426-w · Cited by 1 · see citing works
Randomized Controlled Trials and the Efficacy of Psychotropic Medications
Dunlop, B. W., & Ribeiro, C. M. D. F. (2019) · Springer eBooks · doi:10.1007/978-3-319-56015-1_4-1 · Cited by 1 · see citing works
Seifert, J., Bleich, S., & Seifert, R. (2023) · Springer eBooks · doi:10.1007/978-3-662-68371-2_22 · Cited by 1 · see citing works
Lin, J., Liu, H., Wang, Z., Wu, C., Li, Y., Zhou, J., Xu, G., Pan, M., Chen, Z., Li, W., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.096 · Cited by 1 · see citing works
Irizarry, R., Gomez, A. E. S., Miles, S., & Acosta, J. T. (2022) · Case Reports in Psychiatry · doi:10.1155/2022/3813929 · Cited by 1 · see citing works
The nature of depression in bipolar disorder
Perich, T., Mitchell, P. B., & Moustafa, A. A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817676-4.00009-2 · Cited by 1 · see citing works
Data impress…but beliefs seduce
Gitlin, M. J. (2019) · Bipolar Disorders · doi:10.1111/bdi.12777
Self-citationAnother Step Toward Clarifying the Benefits and Burdens of Selective Serotonin Reuptake Inhibitors
Wulsin, L. R. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000735
The case for and against selective serotonin reuptake inhibitors in rapid cycling bipolar disorder
Semenov, D., & Quinn, J. (2021) · University of Western Ontario Medical Journal · doi:10.5206/uwomj.v89i1.8588
Manic Episode Induced by Lamotrigine in Rapid Cycling Bipolar Disorder
Ramos, A. L., Salgado, H., & Bragança, M. (2021) · Cureus · doi:10.7759/cureus.16184
Musetti, L., Tundo, A., Cambiali, E., Grande, C. D., de Filippis, R., Franceschini, C., Proietti, L., Betrò, S., Marazziti, D., & Dell’Osso, L. (2021) · CNS Spectrums · doi:10.1017/s109285292100078x
Evidence-Based Principles for Bipolar Disorder Treatment
(2019) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.17303
Li, Y., Ji, Y., & Luo, Q. (2023) · PubMed Central · doi:10.7518/hxkq.2023.2022448
The woman whose kidneys could not handle lithium
Gilfert, J. (2024) · Cambridge University Press eBooks · doi:10.1017/9781108623872.025
- Authors
- Gitlin, M. J.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Gitlin, Michael J.
- ORCID
- Gitlin, Michael J.
- Venue
- International Journal of Bipolar Disorders
- Published
- 2018-12
- Volume
- 6
- Issue
- 1
- Pages
- 25-25
- ISSN
- 2194-7511 (ISSN-L)
- PMC
- PMC6269438
- OpenAlex
- W2895700889
- Cited by
- 116
- References
- 63
- Citations by year
- 2026: 14 · 2025: 24 · 2024: 15 · 2023: 16 · 2022: 15 · 2021: 13 · 2020: 11 · 2019: 8
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Bipolar Disorders (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- International Society for Bipolar Disorders
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- antidepressants, bipolar depression, bipolar disorder, tricyclic antidepressants, selective serotonin reuptake inhibitors, bipolar II depression, bipolar I disorder, mixed features, rapid cycling, stimulant abuse, antidepressant monotherapy, mood stabilizers, maintenance therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
