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You may already know the names of some of the most popular antidepressants such as Prozac (fluoxetine), Zoloft (sertraline), Wellbutrin (bupropion), Effexor (venlafaxine), Pristiq (desvenlafaxine), Celexa (citalopram), Cymbalta (duloxetine), Lexapro (escitalopram), etc. These drugs are extremely effective for depression treatment, but must be used with extreme caution in people with bipolar disorder, as they have a high risk of inducing mania. This simply can’t be stressed enough. Antidepressants can lead to increased rapid cycling and severe mania in people with bipolar disorder, and should never be used alone. They can be used, however, in conjunction with other mood stabilizers under careful doctor supervision with regular medication reviews. I know many people with bipolar disorder who use them successfully in this way. Common antidepressant side effects include agitation, weight loss or weight gain, headache, stomach upset, irritable bowel syndrome, sexual side effects, loss of appetite, leg-shaking, sleepiness, and most importantly, suicidal tendencies. It is essential that you and your health care professional look for signs of suicidal thoughts and behaviors if you start an antidepressant.
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While some of these potential side effects can be very strong, antipsychotics can be life saving medications that give a person the ability to work and function in society. If you have psychosis and/or full blown mania it is essential that you try multiple antipsychotics before giving up. It’s often possible to start with very low doses and then go up as needed. This is called microdosing. Many people eventually find the right anti psychotic with few side effects.