Discontinuing bipolar medicine early may cause depression relapse

Bipolar disorder, in which a person’s mood cycles between two extremes -- depression and mania -- is usually treated with a mood stabilizer and, when needed, an antidepressant. But researchers at the UCLA Neuropsychiatric Institute have found that the standard use of these drugs often leads to a relapse.

According to established guidelines, the antidepressant should be discontinued within three to six months after a person recovers from an acute episode of depression.

But in following 84 people for one year after successful treatment, researchers found that 70% of the 43 people whose antidepressant was discontinued suffered another bout of depression. Among the 41 who continued taking an antidepressant, only 36% relapsed.

Another finding was that the risk of becoming manic was no higher among those who continued taking an antidepressant. It was thought that staying on the drug would prompt a swing into mania, one reason doctors have recommended discontinuing it within three to six months.

“This study raises the question of whether the current guidelines need to be re-evaluated,” said Dr. Lori Altshuler, lead author and director of the UCLA Mood Disorders Research Program.

This study was published in the July issue of the American Journal of Psychiatry.

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-- Dianne Partie Lange