Fast Five Quiz: Bipolar Disorder With Agitation

W. Clay Jackson, MD, DipTh; Heidi Moawad, MD


February 23, 2023

Monotherapy with antidepressants is contraindicated in patients with bipolar I disorder, as well as during episodes with mixed features, owing to the risk of inducing mania or psychomotor agitation. Bipolar depression is often treated with antipsychotics, such as olanzapine-fluoxetine (in combination), or single agents such as lurasidone or quetiapine. Anticonvulsants, such as lamotrigine or valproic acid, are also appropriate. Although the benefits of antidepressants for patients with bipolar disorder are still controversial, if used, they should be prescribed along with a mood-stabilizing treatment. When starting antidepressants, patients should be closely monitored for signs of mania and/or psychomotor agitation. If symptoms develop, the antidepressant should be discontinued.

Learn more about bipolar disorder.

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