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These may include those with a previous history of response to antidepressants, a history of relapse when taken off antidepressants, or those with inadequate response to first-line agents.[86,87] In all cases where an antidepressant is initiated, patients and caregivers should be educated about behavioral changes or early warning signs of a manic switch, and antidepressants must be promptly discontinued in case of a treatment-emergent affective switch