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Antidepressant-Associated Mania and Psychosis Resulting in Psychiatric Admissions

Adrian Preda, M.D.; Rebecca W. MacLean, M.D.; Carolyn M. Mazure, Ph.D.; and Malcolm B. Bowers, Jr., M.D.

Background: The safety and tolerability of the selective serotonin reuptake inhibitors and the newer atypical agents have led to a significant increase in antidepressant use. These changes raise concern as to the likelihood of a corresponding increase in adverse behavioral reactions attributable to these drugs.

Method: All admissions to a university-based general hospital psychiatric unit during a 14-month period were reviewed.

Results: Forty-three (8.1%) of 533 patients were found to have been admitted owing to antidepressant-associated mania or psychosis.

Conclusion: Despite the positive changes in the side effect profile of antidepressant drugs, the rate of admissions due to antidepressant-associated adverse behavioral effects remains significant.

(J Clin Psychiatry 2001;62:30-33)

Received Dec. 27, 1999; accepted May 17, 2000. From the Department of Psychiatry, Yale University, New Haven, Conn.

Reprint requests to: Malcolm B. Bowers, Jr., M.D., Department of Psychiatry, Yale University, 25 Park St., GB 624, New Haven, CT 06519.