Bipolar Disorder Treatment Medications SSRIs or Selective Serotonin Reuptake Inhibitors By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Marcia Purse Medically reviewed by Medically reviewed by Daniel B. Block, MD on December 04, 2020 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Review Board Daniel B. Block, MD Updated on February 07, 2021 Print Jonathan Nourok / Getty Images What Are SSRIs? SSRIs, or selective serotonin reuptake inhibitors, are the most commonly prescribed antidepressants in the U.S. As their name suggests, SSRIs are used to treat depression. SSRIs are believed to improve mood and treat depression by increasing serotonin levels in the brain. Because of their ability to boost a person's mood, doctors also prescribe SSRIs to treat other mood-related disorders, like anxiety or bipolar disorder. List of SSRIs Below is a list of SSRIs currently prescribed in the U.S.: Celexa (citalopram)Lexapro (escitalopram)Luvox (fluvoxamine)Paxil (paroxetine)Prozac (fluoxetine)Zoloft (sertraline)Trintellix (vortioxetine)Viibryd (vilazodone) SSRIs and Bipolar Disorder Using antidepressants like SSRIs in bipolar disorder is controversial. Some doctors avoid prescribing them because of evidence showing they worsen bipolar symptoms and trigger manic episodes in people with bipolar depression. These risks are even greater for those prone to rapid cycling. Others find no evidence of this increased risk, claiming that antidepressants can be effective when used with a mood stabilizer (such as lithium or valproate). And then there are those who say using an antidepressant in combination with a mood stabilizer is no better than just using a mood stabilizer alone. Lithium is considered the first-line treatment for bipolar depression. The American Psychiatric Association (APA) recommends against using an antidepressant alone to treat bipolar depression. But despite the potential risks, antidepressants like SSRIs are still the most commonly prescribed drug for treating bipolar depression. Doctors are more likely to prescribe an SSRI if you have responded well to one in the past or if your depression is severe. Additionally, if you are not responding to mood-stabilizers alone, your doctor may add on an SSRI. What Happens When I Stop An SSRI? Here is a look at the causes and symptoms of SSRI Discontinuation Syndrome, the uncomfortable reaction some people have to cut down or quit certain types of antidepressants. Here are tips for both pill and capsule handling to ease the effects of lowering your dosage or discontinuing an SSRI antidepressant medication—when a too-abrupt transition could cause troubling symptoms. What Should I Do? If you have bipolar depression and you are taking an SSRI, be sure to discuss with your doctor the potential side effects, and also the signs of a manic episode and rapid cycling. It's important you take your medication, as prescribed. Do not stop your medication without consulting your doctor—this is for your safety and well-being. Was this page helpful? Thanks for your feedback! Dealing with racing thoughts? Always feeling tired? Our guide offers strategies to help you or your loved one live better with bipolar disorder. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. U.S. Food and Drug Administration. Selective Serotonin Reuptake Inhibitors (SSRIs) Information. Updated December 23, 2014. El-Mallakh RS, Vöhringer PA, Ostacher MM, et al. Antidepressants worsen rapid-cycling course in bipolar depression: A STEP-BD randomized clinical trial. J Affect Disord. 2015;184:318-321. doi:10.1016/j.jad.2015.04.054 McGirr A, Vöhringer PA, Ghaemi SN, Lam RW, Yatham LN. Safety and efficacy of adjunctive second-generation antidepressant therapy with a mood stabiliser or an atypical antipsychotic in acute bipolar depression: a systematic review and meta-analysis of randomised placebo-controlled trials. Lancet Psychiatry. 2016;3(12):1138-1146. doi:10.1016/S2215-0366(16)30264-4 Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356(17):1711-1722. doi:10.1056/NEJMoa064135 Baldessarini RJ, Leahy L, Arcona S, Gause D, Zhang W, Hennen J. Patterns of psychotropic drug prescription for U.S. patients with diagnoses of bipolar disorders. Psychiatr Serv. 2007;58(1):85-91. doi:10.1176/ps.2007.58.1.85 Additional Reading American Psychiatric Association. Practice Guideline For The Treatment of Patients With Bipolar Disorder. Salvi V, Fagiolini A, Swartz HA, Maina G, & Frank E. The use of antidepressants in bipolar disorder. J Clin Psychiatry. 2008 Aug;69(8):1307-18.