Question: For adult patients with bipolar disorder using mood stabilisers, does treatment of low mood with SSRIs increase the risk of mania/hypomania, compared with treatment of mood stabilisers alone?

Answer:

No definite clinical implications can be made from the available evidence; no randomised trials were identified that directly compared SSRIs with mood stabilisers alone. Two studies with very small sample sizes were included in this BEST summary, and while it appears that the SSRIs may be associated with low switch rates into mania/hypomania, the results are inconclusive. The authors of both studies suggested that more research is needed.

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