Continuing Adjunctive Antidepressants After Remission in Patients with Bipolar Depression

Antidepressants are prescribed widely for bipolar depression, despite limited evidence of their efficacy for this condition. This multisite trial involved 187 patients with bipolar 1 disorder in whom recent depressive episodes had remitted during treatment with adjunctive antidepressants (i.e., bupropion or escitalopram) added to mood stabilizers. Patients were randomized to continue antidepressants for either 8 or 52 weeks.

Time to next mood episode (either depression or mania/hypomania) was not significantly different in the two groups. Patients in the 52-week group had numerically fewer depressive recurrences but numerically more manic or hypomanic episodes.