What is a primary concern when using antidepressants in patients with bipolar disorder?

The primary concern when using antidepressants in patients with bipolar disorder is the induction of a manic episode. In individuals with bipolar disorder, introducing an antidepressant can provoke a switch from a depressive episode into a manic or hypomanic phase. This occurs because antidepressants, while effective for managing depressive symptoms, may destabilize mood in individuals prone to mood fluctuations.

The risk of inducing mania is particularly significant in patients who are not also receiving a mood stabilizer, as the mood stabilizers are crucial for minimizing the risk of such switches. Therefore, careful assessment and monitoring are necessary when treating bipolar disorder with antidepressants, ensuring that patients are appropriately managed to maintain mood stability. Other concerns associated with antidepressant use, such as weight gain, hypertension, or allergic reactions, are valid but are secondary to the risk of destabilizing the patient's mood and triggering a manic episode.