Why should SSRIs be used cautiously in bipolar patients?

• A. They can precipitate mania
• B. They cause neutropenia
• C. They are ineffective in bipolar
• D. They cause hyperglycemia

Answer: (A)

SSRIs can destabilize mood in bipolar patients by triggering a switch into mania or hypomania. In people with bipolar disorder, antidepressants raise monoaminergic activity, which can lift depressive symptoms but also push susceptible individuals into an elevated mood state. Because of this risk, they’re used cautiously—usually with a mood stabilizer or antipsychotic and with close monitoring for signs of mania. If manic symptoms appear, the antidepressant is adjusted or stopped. The other options don’t capture this core issue: neutropenia isn’t a typical concern with SSRIs, and hyperglycemia isn’t the primary risk in this context, while effectiveness can vary. The key point is the potential to precipitate mania.