This is a controversial question in which the jury has not yet returned. Part of the concern about the use of antidepressants in bipolar disorder is that it appears, in some individuals, that they can increase the frequency of switching between different mood episodes. A number of studies have raised concerns that the use of antidepressants in bipolar disorder increases the likelihood of developing rapid-cycling bipolar disorder.
While there is little consensus, in those people with bipolar disorder for whom an antidepressant is absolutely necessary, it’s important that they be on some kind of mood stabilizing medication at the same time. This strategy has been shown to decrease the rate of antidepressant-associated switching. The addition of a mood stabilizer and/or antipsychotic to an antidepressant can be seen as putting a ceiling, or damper, on how “high” the antidepressant can elevate a person’s mood.