{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:58:04Z","timestamp":1789059484133,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,7,30]]},"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the association between antidepressant therapy and the later onset of mania\/bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using an anonymised electronic health record case register.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>South London and Maudsley National Health Service (NHS) Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>21\u2005012 adults presenting to SLaM between 1 April 2006 and 31 March 2013 with unipolar depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Prior antidepressant therapy recorded in electronic health records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Time to subsequent diagnosis of mania or bipolar disorder from date of diagnosis of unipolar depression, censored at 31 March 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multivariable Cox regression analysis with age and gender as covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall incidence rate of mania\/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania\/bipolar disorder incidence was seen in patients aged between 26 and 35\u2005years (12.3 per 1000 person-years). Prior antidepressant treatment was associated with an increased incidence of mania\/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with selective serotonin reuptake inhibitors (HR 1.34, 95% CI 1.18 to 1.52) and venlafaxine (1.35, 1.07 to 1.70).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania\/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-008341","type":"journal-article","created":{"date-parts":[[2015,12,14]],"date-time":"2015-12-14T22:44:14Z","timestamp":1450133054000},"page":"e008341","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":88,"title":["Do antidepressants increase the risk of mania and bipolar disorder in people with depression? 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