Antidepressant-withdrawal mania - a case report
Introduction An uncommon adverse event of antidepressant discontinuation is the paradoxical withdrawal hypomania or mania. It is rarely described in the literature and its true incidence is unknown, may it be a consequence of underrecognition or misattribution. Objectives Alert clinicians of th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821005435/type/journal_article |
| _version_ | 1797616495901016064 |
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| author | M. Magalhães L. Moreno R. Mendes A. Gamito |
| author_facet | M. Magalhães L. Moreno R. Mendes A. Gamito |
| author_sort | M. Magalhães |
| collection | DOAJ |
| description |
Introduction
An uncommon adverse event of antidepressant discontinuation is the paradoxical withdrawal hypomania or mania. It is rarely described in the literature and its true incidence is unknown, may it be a consequence of underrecognition or misattribution.
Objectives
Alert clinicians of the uncommon Antidepressant-Withdrawal Mania
Methods
Report and discuss, based on online pubmed database, a case of Antidepressant-Withdrawal Mania with Citalopram
Results
A 34 year old woman, with a previous unipolar depressive episode, presents to the emergency department in june/2020 with anxiety, recurrent thoughts of death without a plan, low energy, anhedonia, loss of appetite, sadness and insomnia developing over a period of 7 months. She was prescribed Quetiapine 50 mg XR, Lamotrigine 100 mg, and sent to a psychiatry consultation. After a month and a half there was no important clinical improvement and Citalopram 20 mg was started. The patient reported slow improvement and by august she had a complete symptomatic response. In the beginning of september the patient stopped citalopram abruptly. Three weeks later, she was presented with an irritable mood, increased energy with decreased need for sleep, sweet cravings, easy irritability, racing thoughts, pressure to keep talking and suicidal thoughts. After 2 weeks of Quetiapine 300 mg XR id, Lamotrigine 100 mg id and Olanzapine 5 mg there was a partial symptomatic response.
Conclusions
Antidepressant withdrawal manic states are an under-recognized phenomena, with ill defined patho-physiological pathways and nosology. It is important to continue close follow up of the patient and to investigate whether it can be included on the bipolar spectrum.
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| first_indexed | 2024-03-11T07:42:01Z |
| format | Article |
| id | doaj.art-45be5fb771ec4dd0a878e0017b283a02 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:42:01Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-45be5fb771ec4dd0a878e0017b283a022023-11-17T05:08:20ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S204S20410.1192/j.eurpsy.2021.543Antidepressant-withdrawal mania - a case reportM. Magalhães0L. Moreno1R. Mendes2A. Gamito3Department Of Psychiatry And Mental Health, Setúbal Hospital Center, Setúbal, PortugalDepartment Of Psychiatry And Mental Health, Setúbal Hospital Center, Setúbal, PortugalDepartment Of Psychiatry And Mental Health, Setúbal Hospital Center, Setúbal, PortugalDepartment Of Psychiatry And Mental Health, Setúbal Hospital Center, Setúbal, Portugal Introduction An uncommon adverse event of antidepressant discontinuation is the paradoxical withdrawal hypomania or mania. It is rarely described in the literature and its true incidence is unknown, may it be a consequence of underrecognition or misattribution. Objectives Alert clinicians of the uncommon Antidepressant-Withdrawal Mania Methods Report and discuss, based on online pubmed database, a case of Antidepressant-Withdrawal Mania with Citalopram Results A 34 year old woman, with a previous unipolar depressive episode, presents to the emergency department in june/2020 with anxiety, recurrent thoughts of death without a plan, low energy, anhedonia, loss of appetite, sadness and insomnia developing over a period of 7 months. She was prescribed Quetiapine 50 mg XR, Lamotrigine 100 mg, and sent to a psychiatry consultation. After a month and a half there was no important clinical improvement and Citalopram 20 mg was started. The patient reported slow improvement and by august she had a complete symptomatic response. In the beginning of september the patient stopped citalopram abruptly. Three weeks later, she was presented with an irritable mood, increased energy with decreased need for sleep, sweet cravings, easy irritability, racing thoughts, pressure to keep talking and suicidal thoughts. After 2 weeks of Quetiapine 300 mg XR id, Lamotrigine 100 mg id and Olanzapine 5 mg there was a partial symptomatic response. Conclusions Antidepressant withdrawal manic states are an under-recognized phenomena, with ill defined patho-physiological pathways and nosology. It is important to continue close follow up of the patient and to investigate whether it can be included on the bipolar spectrum. https://www.cambridge.org/core/product/identifier/S0924933821005435/type/journal_article Antidepressant-Withdrawal Maniaadverse event of antidepressant discontinuationbipolar spectrumhypomania mania |
| spellingShingle | M. Magalhães L. Moreno R. Mendes A. Gamito Antidepressant-withdrawal mania - a case report European Psychiatry Antidepressant-Withdrawal Mania adverse event of antidepressant discontinuation bipolar spectrum hypomania mania |
| title | Antidepressant-withdrawal mania - a case report |
| title_full | Antidepressant-withdrawal mania - a case report |
| title_fullStr | Antidepressant-withdrawal mania - a case report |
| title_full_unstemmed | Antidepressant-withdrawal mania - a case report |
| title_short | Antidepressant-withdrawal mania - a case report |
| title_sort | antidepressant withdrawal mania a case report |
| topic | Antidepressant-Withdrawal Mania adverse event of antidepressant discontinuation bipolar spectrum hypomania mania |
| url | https://www.cambridge.org/core/product/identifier/S0924933821005435/type/journal_article |
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