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Bipolar Surprise: Mood disorder endures antidepressant setback

Contrary to the expectations of many mental-health clinicians, a large-scale study finds that severe depression in patients with bipolar disorder responds no better to a combination of antidepressant medications and mood-stabilizing drugs than it does to mood stabilizers alone.

In another challenge to clinical lore, the federally funded investigation indicates that antidepressant use doesn't hasten the emergence of manic symptoms, such as grandiose thinking and euphoric feelings, in patients with bipolar disorder.

Mild-to-severe versions of bipolar disorder afflict nearly 4 percent of adults at some time in their lives. The illness features swings between periods of depression and mania. Treatment typically includes mood stabilizers such as lithium or other mania-reducing drugs. Clinicians often treat bipolar depression with antidepressants as well, although they have worried that these substances may chemically jolt patients from depression into mania.

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