# General Info

Depression in bipolar disorder can be severe and may even cause suicidal thoughts. While antidepressants treat depression, a person with bipolar disorder also experiences bouts of mania. For this reason, antidepressants aren't always the most effective treatment.

Antidepressants increase the amount of neurotransmitters in the brain. Examples include serotonin, norepinephrine, and dopamine. The use of antidepressants for bipolar disorder has been controversial because antidepressants have triggered manic episodes in a small percentage of people with bipolar disorder. [Source](https://www.healthline.com/health/bipolar-disorder/antidepressants#Antidepressants)

Monoamine oxidase inhibitors aka MAOIs (Tranylcypromine/Parnate)

* MAOIs are an older type of antidepressant
* They can cause potentially serious side effects, so a specialist doctor should only prescribe them.

Tricyclic/Tetracyclic antidepressants aka TCAs (Amitriptyline/Elavil, Clomipramine/ Anafranil)

* TCAs are an older type of antidepressant.
* Some tricyclic antidepressants are more likely to cause side effects that affect safety, such as:
   * Disorientation or confusion, particularly in older people when the dosage is too high
   * Increased or irregular heart rate
   * More-frequent seizures in people who have seizures

Noradrenaline and specific serotonergic antidepressants aka NASSAs (Mirtazapine/Remeron)

* NASSAs may be effective for some people who are unable to take SSRIs. The side effects of NASSAs are similar to those of SSRIs but may cause fewer sexual problems. However, they may also cause more drowsiness at first.

Serotonin-norepinephrine reuptake inhibitors aka SNRIs (Duloxetine/Cymbalta, Venlafaxine/Effexor)

* This new class of antidepressants is known as SNRIs because they affect not only serotonin but also norepinephrine and other neurotransmitter systems.
   * Commonly also used to treat major depressive disorder (MDD), anxiety disorders, obsessive-compulsive disorder (OCD), social phobia, attention-deficit hyperactivity disorder (ADHD), chronic neuropathic pain, and fibromyalgia syndrome (FMS), in addition to menopausal symptoms.

Selective serotonin reuptake inhibitors aka SSRIs  (Citalopram/Celexa, Escitalopram/Lexapro)

* Although SSRIs are effective treatments for depression, little is known about how SSRIs affect individuals with bipolar disorders. Despite this fact, they remain a commonly prescribed treatment for bipolar disorders.

## Common side effects:

* Nausea
* Nervousness
* Insomnia
* Diarrhea
* Rash
* Agitation
* Erectile dysfunction
* Loss of libido
* Weight gain or loss

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Please use the thread below to add your experience with these medications. If we have missed a medication, please let us know, and we will add it.

Thanks!