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A 49-year-old male asked:

Is there any ssri/snri which is supposedly safer for a bipolar patient -with least chance of hypomania?

3 doctor answers4 doctors weighed in
Dr. Robert Berkowitz
Psychiatry 36 years experience
I don't like any: Literature does not support a benefit of adding any antidepressant (ad) to a mood stabilizer (ms) for bipolar disorder. Some experts go so far as to say that ads are fundamentally destabilizing, and that a trial of a ms is spoiled by the presence of an ad. That said, many people continue to require an ad. Ssris, especially paxil, (paroxetine) are safer than snris wrt hypomania. I would try seroquel first.
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Dr. Stephen Ash
40 years experience
SNRIs for Bipolar?: Only physicians can recommend which medication to use. However, as snris can trigger manic episodes in bipolar disorders (likely because of the norepinephrine), i would suggest you keep the tegretol and Lamictal but ask your doc to consider switching the Cymbalta to a ssri for your depressive episodes. For examples, see: http://www.Drugs.Com/comments/duloxetine/for-bipolar-disorder.Html.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Alan Ali
Dr. Alan Alianswered
Psychiatry 34 years experience
Antidepressants/Mani: That varies with the patient, how well their moods are controlled, what medications they are on, and if other medical conditions exist. Review with your doctor.
Created for people with ongoing healthcare needs but benefits everyone.

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Last updated Apr 16, 2016


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