This article is freely available to all

Article Abstract

Because this piece does not have an abstract, we have provided for your benefit the first 3 sentences of the full text.

Sir: Dr. Benazzi’s scholarly letter regarding our recent report that antidepressants do not increase suicidality in individuals with bipolar disorder amplifies a point that we reported but did not extensively discuss: that manic symptoms are associated with increased rates of suicidality. Our finding that such symptoms do not mediate antidepressant effects does not mean that these symptoms are not of impact in their own right. On the contrary, manic symptoms are common during bipolar depressive episodes, as Dr. Benazzi’s extensive review points out.’ ‹