Antiepressant-Associated Mania.
- Author:
Doh Joon YOON
1
Author Information
1. Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Korea.
- Publication Type:Review
- Keywords:
Antidepressant;
Psychiatric side effect;
Mania;
Prevalence;
Risk factor;
Mechanism
- MeSH:
Autoreceptors;
Bipolar Disorder*;
Bupropion;
Depression;
Depressive Disorder, Major;
Dopamine;
Female;
Humans;
Mood Disorders;
Norepinephrine;
Prevalence;
Risk Factors;
Risk Management
- From:Journal of Korean Neuropsychiatric Association
1997;36(3):395-415
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
To examine the causative agents, clinical characteristics, management, risk factors, and neurochemical mechanism of the antidepressant-associated mania, MEDLINE searches were conducted. Mania can occur by chance during antideressant treatment or withdrawal, particularly in patients predisposed to mood disorder. Antidepressant-associated mania, especially withdrawal mania, appears to be milder and a more time-limited syndrome than a spontaneous mania and may represent a distinct clinical entity. MAOI, especially RIMA or bupropion may be associated with milder and less manic inductions than either TCA or SSRI. The possible risk factors for antidepressant-induced mania are female, mood disorder, especially bipolar type I, past and family history of mood disorder, especially bipolar type I, long-term treatment, high dose, and combined therapy in treatment-resistant depression, the possible for withdrawal mania are female, mood disorder, especially major depressive disorder, past and family history of mood disorder, especially major depressive disorder, long-term treatment, high dose, abrupt discontinuation or dose reduction, TCA or MAO(except RIMA?). Antidepressant-induced mania can result from dysfunction of mechanisms that maintain noradrenaline/acetylcholine balance associated with the antidepressant-induced activation of noradrenaline system. The mechanism of withdrawal mania with TCA is cholinergic-monoaminergic interaction theory, and with MAOI is related a hyperdopaminergic state due to loss of drug-induced subsensitivity of dopamine autoreceptors. The prevention of these side effects will require further well-designed study on risk factors.
