Antidepressant discontinuation manias: a new bipolar subtype?

IntroductionAntidepressant withdrawal manic states are rare and controversial phenomena. The underlying pathophysiology and the clinical implications have not been thoroughly discussed in the literature.ObjectivesWe aimed to review reports of antidepressant discontinuation manic states and to discus...

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Bibliographic Details
Published in:European psychiatry 2022-06, Vol.65 (S1), p.S109-S110
Main Authors: Abou Kassm, S., Naja, W.
Format: Article
Language:English
Subjects:
Abstract
antidepressant
Antidepressants
Bipolar disorder
bipolar III 1/4
discontinuation
mania
Oral Communication
Pathophysiology
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Summary:IntroductionAntidepressant withdrawal manic states are rare and controversial phenomena. The underlying pathophysiology and the clinical implications have not been thoroughly discussed in the literature.ObjectivesWe aimed to review reports of antidepressant discontinuation manic states and to discuss the different hypothetical pathophysiological changes underlying this phenomenon. We also argued in favor of its inclusion in the bipolar spectrum.MethodsWe searched Pubmed using the key words: ‘antidepressant withdrawal’ or ‘antidepressant discontinuation’ plus ‘mania’ or ‘hypomania’ from January 2008 until January 2018.ResultsTwenty-nine cases of antidepressant discontinuation manic states were identified. Hypotheses involve the implication of Catecholamines, Acetylcholine and Serotonin in the pathophysiology of this paradoxical phenomenon. The search for red flags for bipolar disorder in these case reports revealed psychiatric histories in favor of a bipolar spectrum disorder in 12 individuals while five were already known to have bipolar disorder.ConclusionsAntidepressant discontinuation mania should be considered on the bipolar spectrum.DisclosureNo significant relationships.
ISSN:0924-9338
1778-3585
DOI:10.1192/j.eurpsy.2022.309