Pardon me, but were you addressing your reply to me Dr Singh?
If so, please check the following evidence based guidelines from NICE of UK, THE professional body which guides doctors practise in UK and whose evidence based guidelines are based on the best accumulated evidence in the world and not based on a single professional's experience.
If not, please accept my apologies.
Guidelines say and I cut paste.....
1.4.3 The management of acute episodes: depressive symptoms
Managing acute depressive symptoms in bipolar disorder
has some similarities to managing unipolar depression
. However, in bipolar disorder antidepressants carry the risk of 'switching' to manic states, and they may be involved in cycle acceleration (mood destabilisation). There is only a limited role for maintenance treatment with antidepressants in bipolar depression; prophylactic medication has a greater role. When prescribing an antidepressant, an antimanic agent should also be prescribed...............
Treatment of depressive symptoms
Patients not taking antimanic medication
18.104.22.168 A patient who is prescribed antidepressant medication should also be prescribed an antimanic drug.
The url of the guideline is
Hope this helps the patient anyway.
Joe, I stand by my earlier reply.