Bipolar disorder, a mental illness that whipsaws patients from dizzying highs to crushing lows, can be particularly challenging to treat – especially in children. Like any mental disorder, there is still much to learn about how the disease develops and how to treat it.
Recently, Medscape.com conducted an interview with Stephen Strakowski, M.D., of Dell Medical School at the University of Texas, Austin, and Nassir Ghaemi, M.D., a psychiatry professor from Tufts Medical Center in Boston, about several treatment controversies associated with bipolar disorder.
In his interview, Dr. Ghaemi states antidepressants shouldn’t be used to treat the “vast majority” of patients with bipolar disorder, claiming the class of drugs isn’t effective. More alarmingly, Dr. Ghaemi warns studies have also found that “these agents can cause or worsen rapid-cycling.” It’s a statement borne out by multiple studies, including a recent case published in the Journal of Affective Disorders in 2015, which Dr. Ghaemi co-authored.
The study examined nearly 70 study participants who had “clinically recovered” from bipolar disorder. Eighteen of the patients had rapidly cycling bipolar symptoms. All of the patients had been treated with SSRI antidepressants following depressive episodes. Next, the participants were followed for at least two months while they were taking both an antidepressant medication as well as a mood stabilizer. After this, the patients were randomly divided into two groups, with one group continuing to take the antidepressant, and one discontinuing the drug.
Researchers followed up their study after a year. Although most participants who continued to take the antidepressants had few to no depressive episodes, the patients with rapidly-cycling symptoms who stopped taking the drug experienced, on average, two to four depressive episodes.
Participants with rapidly-cycling symptoms who continued to take antidepressants didn’t fare any better. After a year, when compared to participants without rapidly-cycling symptoms, the rapidly-cycling participants who still took antidepressant medication had much higher rates of depressive and mood episodes than the patients who stopped the antidepressants.
“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,” wrote the study’s researchers.
Additional studies have also found areas of concern with the effects of antidepressants on patients with bipolar disorder.
Bipolar disorder in teens
The teenage years are full of social – and chemical – changes for teens. It’s the time of life when authority gets seriously tested and boundaries explored. Sometimes this can mean minor moments of defiance, or more serious actions such as experimenting with drugs and alcohol. So it’s often easy to mistake normal teen moodiness for something worse or vice versa.
Bipolar disorder in teens is different. The illness creates unusual and very intense mood changes. A teen with bipolar disease may feel so depressed they can’t climb out of bed during a depressive episode, or unusually happy and excited during a manic episode. The National Institute of Mental Health (NIMH) warns the mood swings are often so intense they can affect a teen’s performance in school, relationships with friends and family and even lead to self-harm and suicide. Bipolar disorder can develop at any time, but according to NIMH, it usually manifests in the late teen or early adult years.
Bipolar disorder is a very serious condition that can seriously affect both the patient and those around them. Sovereign Health of Rancho San Diego stays up-to-date on the latest advances and research on bipolar disorder treatment. Our residential treatment center in rural San Diego County gives adolescents a safe space to achieve recovery and reach their full potential. For more information, contact our 24/7 helpline.
About the author
Brian Moore is a staff writer and graphic designer for Sovereign Health. A 20-year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which he’s done with varying degrees of success for over 25 years. For more information and other inquiries about this media, contact the author and designer at firstname.lastname@example.org.