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Taper and conservative switch with a medication-free washout period. Since some tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) can cause harmful interactions if used ...
In adults and children with bipolar disorder, SSRIs may cause a bipolar switch from depression into hypomania/mania, mixed states or rapid cycling. [159] When taken with mood stabilizers , the risk of switching is not increased, however when taking SSRIs as a monotherapy , the risk of switching may be twice or three times that of the average.
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Two or more antidepressants taken together, from either the same or different classes (affecting the same area of the brain, often at a much higher level). An antipsychotic combined with an antidepressant, particularly atypical antipsychotics such as aripiprazole (Abilify), quetiapine (Seroquel), olanzapine (Zyprexa), and risperidone (Risperdal).
Among the patients who were switched to a different antidepressant, there was no significant difference among the different antidepressants. For level three, the remission rates based on the HAM-D symptom scale were 12.3% for mirtazapine and 19.8% for nortriptyline, although the difference was not large enough for statistical significance. [5]
The mania prevention and antidepressant effects of valproic acid have not been well demonstrated. [2] Valproic acid is less effective than lithium at preventing and treating depressive episodes. [17] Carbamazepine was the first anti-convulsant shown to be effective for treating bipolar mania. It has not been extensively studied in bipolar ...
However, there are differences between TCA related antidepressants and classical TCAs in terms of side effect profiles and withdrawal when compared to SSRIs. [67] There is evidence a prominent side-effect of antidepressants, emotional blunting, is confused with a symptom of depression itself. The cited study, according to Professor Linda Gask was:
This translates to the 2nd- and 3rd-most-common antidepressants, behind Lexapro (escitalopram), an SSRI. [88] In some studies, SNRIs demonstrated slightly higher antidepressant efficacy than the SSRIs (response rates 63.6% versus 59.3%). [43] However, in one study escitalopram had a superior efficacy profile to venlafaxine. [89]
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