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ANTIDEPRESSANTS for BIPOLARS

© Colleen Sullivan

Antidepressant drugs are a second group of medicines widely used in the treatment of episodes of major depression associated with Bipolar Affective Disorder. Great care must be taken in the use of these agents in bipolar disorder because of the possibility of their pushing a bipolar into a manic phase or speeding up their cycling. To avoid this, psychiatrists usually prescribe lithium or another mood stabilizer before beginning an antidepressant. Sometimes the mood stabilizer alone proves to be adequate; if not, an antidepressant is added later.

As with the discovery of lithium, serendipity led to the discovery of the first antidepressants in the 1950's. First researchers were trying to develop a new anti psychotic agent and discovered imipramine, then a new anti tuberculosis medication isoniazid was found to make patients so ebullient that some danced in the hallways. This was the forerunner to the monoamine oxidase (MAO) inhibitors.

From then on, researchers continued to discover new and effective medications for the treatment of major depression. A question often asked is how do they work? It was long believed that all antidepressants work by increasing or decreasing levels of various neurotransmitters involved in depression, such as serotonin and norepinephrine. It is now known the therapeutic effects of these drugs have more to do with cellular function and the transmission of impulses via receptors than with the neurotransmitter levels themselves.

Generations of Antidepressants

Antidepressant medications have been divided into generations according to time of discovery and chemical structure:

First Generation Antidepressants the tricyclics (tofranil, elavil, sinequan, asendin etc and the MAO Inhibitors (Nardil, Parnate)

Second Generation Antidepressants include Wellbutrin and Desyrel, both atypical antidepressants that are chemically different than the other classes of antidepressants.

Third Generation Antidepressants are selective serotonin reuptake inhibitors or SSRI's. Included in this generation are prozac, luvox, paxil and zoloft.

Fourth Generation Antidepressants were released by the FDA in 1994 and include serzone and effexor.

For excellent information on any individual antidepressant drug go to RX List at http://www.rxlist.com

Health Center also offers an easy to use listing of antidepressants and their uses, side effects etc. Easy to read. See it at http://www.health-center.com/english/pha...

RxMed Pharmaceuticals offers excellent information about all medications at http://www.rxmed.com/prescribe.html

BE AWARE!!

Every medication has side effects. Learn about your medication. Read, ask questions and be alert to signs of problems within yourself. Contact your doctor if you are having problems. The first medication prescribed is not always the best one for you.

OK! YOU'RE BIPOLAR and AN ANTIDEPRESSANT HAS BEEN PRESCRIBED