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Bipolar disorder - Management
What advise should I give to someone taking SSRIs?
- Advise the person that:
- Craving and tolerance do not occur, and that taking medication should not be seen as a sign of weakness.
- Manic or hypomanic switching may occur.
- There may be a delay in the onset of effect, with a gradual and fluctuating improvement.
- Medication should be taken as prescribed.
- Stopping the treatment may result in withdrawal symptoms such as gastrointestinal disturbances, headache, anxiety, dizziness, paraesthesia, sleep disturbances, fatigue, influenza-like symptoms, and sweating.
- The dose is usually tapered down over a few weeks to avoid withdrawal effects.
- They should be aware of symptoms of akathisia (e.g. restlessness), suicidal ideation, and increased anxiety and agitation (particularly in the initial stages of treatment). They should seek help promptly if these adverse effects are distressing.
[National Collaborating Centre for Mental Health, 2006]
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