Whether antidepressants should be prescribed to treat depression in bipolar disorder has been debated for decades. At the core of this debate is weighing the clinical benefit of antidepressant treatment against risk of worsening the illness by inducing mania or instability. Our study suggests that use of an antidepressant in conjunction with a mood stabilizer does not increase the risk of mania. This is important because treatment options for bipolar depression are urgently needed; patients with bipolar disorder spend most of their time in depressive episodes, and depressive symptoms are the leading cause of impairment and morbidity in bipolar patients.