Researchers from the University of British Columbia have made a discovery that might change the way we deal with bipolar disorder.
They found that modern antidepressants might help people with this condition avoid falling back into a depressive episode. Their findings were published in a medical journal called the New England Journal of Medicine.
Dr. Lakshmi Yatham, who led the study, said treating depression in bipolar disorder is hard. It can be very tough for the patients and their families when they have a depressive episode.
He also pointed out that lowering the chances of having another episode is important because it can bring stability to patients’ lives and help them get back to doing the things they love.
The Challenges of Bipolar Disorder
Bipolar disorder is a condition that causes a person’s mood to swing between extreme highs and lows. During the highs, they might feel very excited or overly energetic.
But during the lows, they might feel very sad and hopeless. They might also lose interest in things they usually enjoy, have trouble sleeping, eat more or less than usual, or even think about suicide.
Doctors often treat depressive episodes in bipolar disorder with a combination of antidepressants, mood stabilizers, and other types of medications.
But there’s a debate about how long this treatment should last. Some people worry that antidepressants might make the highs and lows come more frequently or make them more severe.
The current guidelines from Canadian and international health organizations suggest stopping antidepressant treatment about eight weeks after the depression lifts.
But, according to Dr. Yatham, this is an area that hasn’t been studied much and doctors don’t agree on what the best approach is. Some research shows that up to 80% of patients keep taking antidepressants for six months or longer.
A New Perspective on Antidepressant Treatment
Now, the first ever global clinical trial looking at how long antidepressants should be used in bipolar disorder treatment has found that extending the treatment period might help prevent depressive episodes from coming back.
The trial took place in Canada, South Korea, and India. It involved 178 patients with bipolar disorder who were no longer experiencing a depressive episode after being treated with modern antidepressants.
Half of these patients continued their antidepressant treatment for a year, while the other half gradually stopped taking their antidepressants over six weeks and then switched to a placebo.
The study found that 46% of the patients in the placebo group had a mood episode come back over the year. This happened to only 31% of the patients who kept taking the antidepressants.
When the researchers looked at the period from week six onwards, they found that the patients who continued with the antidepressants were 40% less likely to have a mood episode come back and 59% less likely to have a depressive episode.
There was no big difference in how many manic episodes the two groups had or how many side effects they experienced.
The Impact of the Study
People with bipolar disorder typically experience depressive symptoms three times more often than manic symptoms.
Past studies have shown that they are much more likely to attempt suicide or die by suicide during a depressive episode than a manic one.
Dr. Yatham highlighted that stabilizing patients and preventing relapse can quite literally be lifesaving.
He believes that future revisions of bipolar guidelines will incorporate the evidence from this study and contribute to changes in clinical practice on how antidepressants will be used to manage patients with bipolar disorder.
The study was a collaborative effort between researchers at UBC and other study sites in Canada, India, and South Korea.
If you care about health, please read studies that scientists find a core feature of depression and this metal in the brain strongly linked to depression.
For more information about health, please see recent studies about drug for mental health that may harm the brain, and results showing this therapy more effective than ketamine in treating severe depression.
The study was published in the New England Journal of Medicine.
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