Text Version
Entrez PubMed Overview Help | FAQ Tutorial New/Noteworthy E-Utilities
PubMed Services Journals Database MeSH Database Single Citation Matcher Batch Citation Matcher Clinical Queries LinkOut Cubby
Related Resources Order Documents NLM
Gateway TOXNET Consumer
Health Clinical Alerts ClinicalTrials.gov PubMed
Central
Privacy Policy
|
|
-
Switch to mania upon
discontinuation of antidepressants in patients with mood disorders: a
review of the literature.
Ali S, Milev
R.
Queen's University, Kingston, Ontario.
shereseali@hotmail.com
OBJECTIVE: To review the literature for
reported cases of mania related to discontinuing antidepressant
treatment, as well as for possible explanations of this phenomenon, and
to present a case report. METHOD: We undertook a literature review
through the PubMed index, using the key words mania, antidepressant
withdrawal, and antidepressants in bipolar disorder. We reviewed 11
articles featuring 23 cases. Where available, we noted and tabulated
certain parameters for both bipolar disorder (BD) and unipolar
depression. We use a case example to illustrate the phenomenon of mania
induced by antidepressant withdrawal. RESULTS: For patients with
unipolar depression, we found 17 reported cases of mania induced by
antidepressant withdrawal. Antidepressants implicated included tricyclic
antidepressants (TCAs) (12/17), monoamine oxidase inhibitors (MAOIs)
(2/17), trazodone (1/17), mirtazapine (1/17), and paroxetine (1/17). For
patients with BD, we found 19 reported cases of mania induced by
antidepressant withdrawal, including our own case example. Of these,
selective serotonin reuptake inhibitors (SSRIs) (10/19), TCAs (4/19),
MAOIs (2/19), and serotonin norepinephrine reuptake inhibitors (SNRIs)
(2/19) were implicated. CONCLUSION: Our case report supports the
observation of antidepressant withdrawal-induced mania in patients with
BD. It is distinguishable from antidepressant-induced mania,
physiological drug withdrawal, and mania as a natural course of the
illness. Many theories have been put forward to explain this occurrence.
Noradrenergic hyperactivity and "withdrawal-induced cholinergic
overdrive and the cholinergic-monoaminergic system" are the 2 most
investigated and supported models. The former is limited by poor
clinical correlation and the latter by its applicability only to
anticholinergic drugs.
Publication Types:
PMID: 12776393 [PubMed - indexed for
MEDLINE]
|