What are the best and worst ssri's/snri's to take if someone is bipolar...Like to try Zoloft (sertraline) my dr. Seems to brush it off?
I try to avoid SSRIs. ; snri's in general w bipolar patients (due to concerns about flipping into hypomania or mania). I usually go for mood stabilizers and have some patients on atypical antipsychotics as well. I do have some patients who have bipolar disorder and anxiety disorders on antidepressants - but only if they are already stabilized on mood stabilizer/ atypical antipsychotic. Discuss w your psychiatrist.
Better to avoid. Especially in bipolar I disorder, even medium term use of any antidepressant carries risk of triggering mania. Long-term use carries risk of poorer long-term prognosis. In bipolar ii disorder, evidence regarding safety of antidepressants is still contradictory. But, if used, they should be used for short periods of time and with very close monitoring. Hope this heps.