What antidepressants are suitable for bipolar disorder?

Antidepressants should be used with great caution in patients with bipolar disorder and must be administered under medical supervision in combination with mood stabilizers. Commonly used medications include sertraline hydrochloride capsules, fluoxetine hydrochloride dispersible tablets, paroxetine hydrochloride tablets, venlafaxine hydrochloride capsules, and mirtazapine tablets. A detailed analysis is as follows:

1. Sertraline Hydrochloride Capsules: This medication belongs to the selective serotonin reuptake inhibitor (SSRI) class and selectively acts on neurotransmitters. It is suitable for depressive episodes in bipolar disorder, effectively improving symptoms such as low mood and reduced interest. It also has some inhibitory effect on manic episodes and should be initiated at a low dose.

2. Fluoxetine Hydrochloride Dispersible Tablets: Also an SSRI, this drug provides sustained and stable effects. It can alleviate core depressive symptoms in bipolar patients and carries a relatively lower risk of inducing manic switch, making it commonly used during acute and consolidation phases of treatment. It has a long metabolic half-life.

3. Paroxetine Hydrochloride Tablets: This agent has strong antidepressant effects and helps regulate central nervous system function. It improves anxiety symptoms associated with bipolar depression and has a relatively rapid onset of action. However, it must be used in conjunction with a mood stabilizer to avoid triggering mania when used alone.

4. Venlafaxine Hydrochloride Capsules: As a serotonin-norepinephrine reuptake inhibitor (SNRI), it has a more comprehensive mechanism of action. It is suitable for bipolar depression patients with somatic symptoms, helping to relieve discomfort such as fatigue and pain. Dosage should be adjusted according to the individual's clinical condition.

5. Mirtazapine Tablets: This medication offers both antidepressant and sedative effects, improving sleep quality. It is particularly suitable for bipolar depression patients with insomnia, providing rapid relief from low mood and sleep disturbances. It has relatively mild side effects and minimal impact on appetite.

Medication for bipolar disorder must strictly follow the principle of individualization; self-selection or adjustment of drugs is not allowed. Close monitoring of mood changes is essential during treatment. Combining pharmacotherapy with psychotherapy and lifestyle modifications can help achieve better stability of the illness.