Article Publish Status: FREE
Abstract Title:

Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study.

Abstract Source:

BMJ Open. 2015;5(12):e008341. Epub 2015 Dec 14. PMID: 26667012

Abstract Author(s):

Rashmi Patel, Peter Reiss, Hitesh Shetty, Matthew Broadbent, Robert Stewart, Philip McGuire, Matthew Taylor

Article Affiliation:

Rashmi Patel


OBJECTIVES: To investigate the association between antidepressant therapy and the later onset of mania/bipolar disorder.

DESIGN: Retrospective cohort study using an anonymised electronic health record case register.

SETTING: South London and Maudsley National Health Service (NHS) Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK.

PARTICIPANTS: 21 012 adults presenting to SLaM between 1 April 2006 and 31 March 2013 with unipolar depression.

EXPOSURE: Prior antidepressant therapy recorded in electronic health records.

MAIN OUTCOME MEASURE: Time to subsequent diagnosis of mania or bipolar disorder from date of diagnosis of unipolar depression, censored at 31 March 2014.

METHODS: Multivariable Cox regression analysis with age and gender as covariates.

RESULTS: The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder incidence was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with selective serotonin reuptake inhibitors (HR 1.34, 95% CI 1.18 to 1.52) and venlafaxine (1.35, 1.07 to 1.70).

CONCLUSIONS: In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.

Study Type : Human Study

Print Options

Sayer Ji
Founder of

Subscribe to our informative Newsletter & receive The Dark Side of Wheat Ebook

Our newsletter serves 500,000 with essential news, research & healthy tips, daily.

Download Now

The Dark Side of Wheat

This website is for information purposes only. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease or medical condition. Before beginning any type of natural, integrative or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional.

© Copyright 2008-2023, Journal Articles copyright of original owners, MeSH copyright NLM.