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Dr G- Can Bipolar medication cause ill side effects?
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Anon_177534 posted:
Why do most of the medications used for Bipolar Disorder warn about side effects such as depression, increased suicidal ideation, anxiety etc.? Does the actual medication cause these symptoms or does the individual person's body act adversely toward the medication itself?
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Joseph F Goldberg, MD responded:
Dear Anon,

In children and young adults up to age 24, antidepressants (including mood stabilizers that have antidepressant properties) have been deemed by the FDA to pose a paradoxical risk for worsening suicidal thoughts or behaviors. The scientific community has many skeptics of that data, however. More broadly, when drug companies do studies for FDA approvals, they must spontaneously report all possible side effects that patients complain of...which means that if someone who enters a study for treatment of depression or anxiety says that they are still having depression or anxiety, the ongoing symptoms get recorded as if they were side effects. You may think this makes little sense, and you would be right. There are many other complaints that get reported as side effects which are clearly unrelated to a drug (e.g., accidents, personality disorders) which nevertheless get counted if someone complains of a problem. Studies compare rates of such complaints between active drug versus placebo, and the FDA looks at whether there are differences between the two if determining if there is or isn't a real risk.

- Dr. G.
 
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An_243880 replied to Joseph F Goldberg, MD's response:
I work with Adverse Event reports for clinical trials involving chemotherapy agents. Dr. G.'s assessment is exactly what I've found during my work. It is amazing what constitutes an adverse even for a study medication. Teasing out what reaction is expected for a patient's condition and what is truly an event attributable to the treatment under study is a challenging scientific balancing act.
 
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casa222 replied to An_243880's response:
Thank you for both of your responses. A lot of the bizarre and strange side effects that I have read about in the past suddenly make sense. Thank you for the education.


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