The use of antidepressants for bipolar disorder - a controversy between science and clinical practice

Depressive episodes are more challenging for patients and clinicians than other bipolar disorder episodes. The reasons for this include: 1. the prevalence of depressive episodes is higher than for other episodes; 2. functioning; 3. cognition is more impaired; 4. suicide is more prevalent; 5. and treatment is more complex. This paper aims to highlight the controversy between the poor evidence from science on the effects of antidepressants for bipolar depression versus the high use of antidepressants in clinical practice, and to specify the clinical role of antidepressants in bipolar disorder in relation to other drugs.