In bipolar disorder, what is the rationale for not using antidepressants as monotherapy during mania?

• A. They can precipitate or worsen mania; mood stabilizers or antipsychotics are preferred
• B. They are not effective in mania
• C. They cause metabolic complications
• D. They require hospitalization

Answer: (B)

When mania is present in bipolar disorder, antidepressants are avoided as monotherapy because they can trigger a switch into mania and are not reliably effective for treating manic symptoms. Mood stabilizers or antipsychotics provide more reliable control of mania and reduce agitation, helping to stabilize mood. Antidepressants may be considered later for bipolar depression, but only alongside a mood stabilizer or antipsychotic to prevent a manic switch, not as stand-alone therapy for mania.