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Lurasidone-induced mania: A case report

Published online by Cambridge University Press:  01 September 2022

T. Fernández*
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
L. Navarro
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
O. Marco
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
L. Tardon
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
N. Arbelo
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
L. Ilzarbe
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
P. Barrio
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
I. Pacchiarotti
Affiliation:
Hospital Clínic Barcelona, Psychiatry, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Lurasidone is an atypical antipsychotic agent with potential antidepressant effects through its antagonist activity at the 5-HT7 receptor. Although treatment-emergent affective switch (TEAS) induced by second-generation antipsychotics are not frequent, several cases have been reported. To our knowledge, there is no evidence of lurasidone-induced TEAS.

Objectives

To describe a case of lurasidone-induced mania.

Methods

We describe a clinical case of a patient admitted to our psychiatric outpatient unit who developed a manic episode, presumably induced by the introduction of lurasidone. We also conduct a review of the literature on this subject.

Results

A 37-year-old man diagnosed with obsessive-compulsive disorder (OCD) and an alcohol use disorder was hospitalized due to OCD decompensation with depressive symptomatology and suicidal thoughts, and for alcohol detoxification process. Since he had a previous history of clomipramine-induced TEAS, he was started on lurasidone up to 111mg to avoid the use of antidepressants, showing a progressive improvement of depressive symptoms. Thus, the patient was discharged when alcohol detoxification process was completed. Eight days after discharge, the patient began to show manic symptoms, so he had to be readmitted. Lurasidone was discontinued and valproic acid up to 1000mg/day as mood stabilizer was added, presenting a positive remission of manic symptoms.

Conclusions

According to our experience, lurasidone may have induced an affective switch in this patient. Based on our findings, patients and psychiatrists should monitor possible lurasidone-induced mood switching. However, further research is needed in order to back-up this one case report findings.

Disclosure

No significant relationships.

Type
Abstract
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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