Antidepressant induced mania in obsessive compulsive disorder

Berk, Michael; Koopowitz, Leslie; Szabo, Christopher Paul

doi:10.1016/0924-977x(95)00046-r

Cited by 17 publications

(11 citation statements)

References 22 publications

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“…Likewise, the affective episode could not be conceptualized as either postictal or interictal psychiatric morbidity because the patient's seizures were well controlled before the emergence of such symptoms and because studies document that interictal psychosis usually appears several years after the onset of epilepsy [6]. While it is unknown whether organic factors might amplify the risk of manic switch, the fact that this patient had neither bipolar disorder before citalopram therapy nor family predisposition supports previous reports of citalopram‐induced manic symptoms in patients with no known bipolar diathesis [4,5]. Another intriguing issue is the onset of manic symptoms while the patient was on a mood‐stabilizing antiepileptic agent, oxcarbamazepine.…”

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confidence: 54%

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Citalopram-induced manic switch in an adolescent with epilepsy

Ameen

Jagadheesan

Sinha

2003

Aust N Z J Psychiatry

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Quetiapine is known to have virtually no risk of extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) [1]. I am aware of one published case report of EPS associated with quetiapine [2]. I now present three further cases of EPS associated with quetiapine.Mr A, a 31-year-old with chronic paranoid schizophrenia, had been stable on 20 mg/day of olanzapine and 300 mg/day of bupropion sustained release. As a response to weight gain, olanzapine was tapered off, and 50 mg twice a day of quetiapine was started and raised to 300 mg/day; 300 mg/day of bupropion sustained release was maintained as before. Two weeks after taking 300 mg/ day quetiapine, Mr A complained that his arms and legs were stiff, his jaw became tight, and his tongue felt thick. He showed cogwheel rigidity of both elbows. Benzatropine 2 mg intramuscular relieved these symptoms.Ms B, a 46-year-old with chronic paranoid schizophrenia, had been stable on 10 mg/day of olanzapine. Recently, she manifested cogwheel rigidity and resting tremor of both hands. Olanzapine was discontinued, and the rigidity and tremor abated. Quetiapine 50 mg twice a day was initiated and raised to 200 mg daily. After 2 weeks, she showed mild cogwheel rigidity of both elbows and wrists and resting tremor of both hands. Benztropine 1 mg twice daily resulted in a reduction of these symptoms.Mr C, a 37-year-old with schizoaffective disorder, had been stable for 2 years on 100 mg/day of quetiapine, 50 mg/day of thioridazine, 2 mg/day of trihexyphenidyl and 500 mg/day of diavalproex. Thioridazine and trihexyhenidyl were discontinued, quetiapine was raised to 200 mg daily; diavalproex was maintained as before. After 3 weeks, Mr C showed typical parkinsonian tremor of both hands and cogwheel rigidity of both elbows and wrists. As trihexyphenidyl produced dry mouth, 200 mg of amantadine twice daily was initiated with reduction of the tremor and rigidity.Attention should be paid to the potential occurrence of EPS in patients on quetiapine. Of course, association in these cases does not necessarily mean cause.

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confidence: 54%

“…Antidepressants such as citalopram are increasingly being used in adolescents [1,2]. Although SSRIs appear to carry a lower risk for manic switch than tetracyclic antidepressants [3], a switch of mania has been reported in adults [4,5]. We are not aware, however, of previous reports of a manic switch with citalopram in an adolescent, and report such a case.…”

mentioning

confidence: 99%

Citalopram-induced manic switch in an adolescent with epilepsy

Ameen

Jagadheesan

Sinha

2003

Aust N Z J Psychiatry

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“…Fluoxetine, paroxetine, clomipramine, ßuvoxamine and citalopram have all been reported to induce mania in patients su¤ering from OCD (Steiner 1991;Vieta and Bernardo 1992;Mundo et al 1993;Christensen 1995;Berk et al 1996). Je¤erson et al (1991) found a 25 % switchover in OCD patients treated with ßuvoxa-mine.…”

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confidence: 96%

Antidepressant-associated mania: a study of anxiety disorders patients

et al. 1998

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Antidepressants are related to the emergence of manic and hypomanic episodes in mood disorder patients. This study examined whether antidepressant-associated manic states are also present in anxiety disorder patients, so that this phenomenon may be defined as a side-effect. A total of 167 consecutive patients at a specialized outpatient clinic, suffering from anxiety disorders and treated by antidepressants, were assessed in a blind, retrospective chart review. Five patients (2.99%) were identified as having suffered an episode of antidepressant-associated mania within 3 months of initiation of treatment. All were females and all had an axis II diagnosis of a cluster B personality disorder. Antidepressant-associated mania appears to be related to risk factors such as personality disorder, even in non-mood disorder patients, tentatively suggesting that it is not simply an adverse event but rather a reflection of an underlying psychopathology.

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“…Mania. SSRIs can trigger manic symptoms in adults (Berk, Koopowitz, & Szabo, 1996) and children (Diller & Avci, 1999 ;Go, Malley, Birmaher, & Rosenberg, 1998) treated for OCD with antidepressants. Alternately, a subgroup of OCD cases may be '' prebipolar '', independent of drug treatment.…”

Section: Drug Treatment and Comorbiditiesmentioning

confidence: 99%

“…Alternately, a subgroup of OCD cases may be '' prebipolar '', independent of drug treatment. Additional investigation is needed to understand when such cases reflect drug effects or the unmasking of underlying bipolar mood disorder (see Berk et al, 1996).…”

Section: Drug Treatment and Comorbiditiesmentioning

confidence: 99%

Practitioner Review: Treatment of Obsessive‐Compulsive Disorder in Children and Adolescents

Rapoport

Inoff‐Germain

2000

Child Psychology Psychiatry

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This paper reviews the treatment of obsessive-compulsive disorder (OCD) in children and adolescents. Focusing on clinical features of the disorder and its treatment particular to pediatric onset, diagnosis, assessment, and behavioral, pharmacological, as well as new investigative treatments are covered. Adaptation of cognitive-behavioral therapy for children and adolescents, use of augmenting agents in drug treatment, and subtyping of OCD cases are developments relevant for current practice.

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Antidepressant induced mania in obsessive compulsive disorder

Cited by 17 publications

References 22 publications

Citalopram-induced manic switch in an adolescent with epilepsy

Citalopram-induced manic switch in an adolescent with epilepsy

Antidepressant-associated mania: a study of anxiety disorders patients

Practitioner Review: Treatment of Obsessive‐Compulsive Disorder in Children and Adolescents

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