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Antidepressant discontinuation manias: a new bipolar subtype?

Published online by Cambridge University Press:  01 September 2022

S. Abou Kassm  and
W. Naja
S. Abou Kassm*
Affiliation:
Center Hospitalier Guillaume Regnier, Brittany, Rennes, France
W. Naja
Affiliation:
King Hussein Cancer Center, King Hussein Cancer Center, Amman, Jordan
*
*Corresponding author.

Abstract

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Introduction

Antidepressant withdrawal manic states are rare and controversial phenomena. The underlying pathophysiology and the clinical implications have not been thoroughly discussed in the literature.

Objectives

We 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.

Methods

We searched Pubmed using the key words: ‘antidepressant withdrawal’ or ‘antidepressant discontinuation’ plus ‘mania’ or ‘hypomania’ from January 2008 until January 2018.

Results

Twenty-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.

Conclusions

Antidepressant discontinuation mania should be considered on the bipolar spectrum.

Disclosure

No significant relationships.

Keywords

antidepressantdiscontinuationbipolar III 1/4mania
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S109 - S110
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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