The authors selectively review the literature in an attempt to assess the effect, if any, of antidepressants on suicidality in bipolar disorder. 3 questions are addressed: can antidepressants induce suicidality by inducing mixed states, especially when administered as monotherapy?; can antidepressants reduce suicidality by treating depressive symptoms, especially when administered in combination with mood stabilizers?; & does age modify the response of bipolarity to antidepressants? Randomized prospective trials, large epidemiological studies & comprehensive reviews were used when available & retrospective chart reviews & open-label studies were included when necessary. (196 refs)