Evidence map›Paper›PMID 41476022›Full record

ArticleBMJ mental health2025

Antidepressant treatment and risk of subsequent bipolar disorder in adolescents with unipolar depression.

Animesh Talukder, Ioanna Kougianou, Kirstie O'Hare, Colm Healy, Ian Kelleher

Abstract read
In one paragraph

Article in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Animesh TalukderInstitute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-4174-3903
Ioanna KougianouInstitute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK.ORCID 0009-0008-0992-5348
Kirstie O'HareInstitute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-1166-9792
Colm HealyInstitute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-7974-1861
Ian KelleherInstitute for Neuroscience and Cardiovascular Research, The University of Edinburgh, Edinburgh, UK ian.kelleher@ed.ac.uk.ORCID 0000-0003-1484-651X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelective serotonin reuptake inhibitors (SSRIs) are a common treatment for depression and anxiety in adolescents but are associated with an increased incidence of bipolar disorder (BD). Whether this relationship is causal remains unclear.

objectiveWe applied a quasi-experimental design to national registry data, using an instrumental variable (IV) approach (regional variation in prescribing practice) to investigate for a causal relationship between adolescent SSRI treatment and subsequent risk of BD.

methodsWe used national electronic health register data on individuals born 1991-1998 followed to maximum age 32 years, looking at individuals diagnosed with unipolar depression in adolescence. Using regional variation in prescribing practice as an IV, we compared risk of BD in adolescents prescribed vs not prescribed SSRIs (fluoxetine, sertraline or citalopram).

findingsIn non-IV analyses, adolescents who were prescribed SSRIs had an increased risk of BD, in keeping with previous research. Subsequent IV analyses, however, did not support a causal relationship between SSRI treatment and BD risk, either in the short or long term. CLINICAL IMPLICATIONS: These findings do not support a causal relationship between SSRI treatment and risk of BD. Rather, they suggest that the apparent relationship between SSRI treatment and later BD may be a result of unmeasured confounding.

Indexed as

Antidepressive AgentsBipolar DisorderDepressive DisorderSelective Serotonin Reuptake InhibitorsAdolescentAdultFemaleFluoxetineHumansMaleRegistriesRisk FactorsYoung AdultAntidepressive AgentsFluoxetineSelective Serotonin Reuptake InhibitorsBipolar and Related DisordersDepressive DisorderMental HealthPsychiatryPsychopharmacology

Identifiers

PMID41476022
PMCPMC12766832

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.