Document Detail

Antidepressant-associated mania: a controlled comparison with spontaneous mania.
MedLine Citation:
PMID:  7943454     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Antidepressants have been associated with the induction of mania and rapid cycling. This study examined whether antidepressant-associated manic states differ in any way from spontaneous mania. METHOD: Forty-nine consecutive inpatients with antidepressant-associated manic states were compared with 49 matched inpatients with spontaneous mania in a blind, retrospective chart review. RESULTS: Across virtually every clinical measure examined, the patients with antidepressant-associated manic states experienced milder and more time-limited manic episodes than the patients with spontaneous mania. The patients with antidepressant-associated manic states were subject to frequent checking by nurses and hall restriction for a significantly shorter period of time than the patients with spontaneous mania. The patients with antidepressant-associated manic states also had significantly less severe levels of delusions, hallucinations, psychomotor agitation, and bizarre behavior, according to a standard rating instrument, than the patients with spontaneous mania. For further study the patients with antidepressant-associated mania were divided into subgroups taking four individual classes of antidepressant drugs: tricyclics (N = 19), fluoxetine (N = 13), monoamine oxidase inhibitors (MAOIs) (N = 8), and bupropion (N = 6); three patients taking combinations of drugs were not included in these analyses. The patients with MAOI- and bupropion-associated mania had a slightly lower overall rating of severity of psychopathology at admission than the subgroups with fluoxetine- and tricyclic-associated mania. CONCLUSIONS: Antidepressant-associated mania appears to be a milder and more time-limited syndrome than spontaneous mania and may represent a distinct clinical entity. MAOIs and bupropion may be associated with milder manic states than either tricyclic drugs or fluoxetine.
A L Stoll; P V Mayer; M Kolbrener; E Goldstein; B Suplit; J Lucier; B M Cohen; M Tohen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of psychiatry     Volume:  151     ISSN:  0002-953X     ISO Abbreviation:  Am J Psychiatry     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1994-11-15     Completed Date:  1994-11-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370512     Medline TA:  Am J Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1642-5     Citation Subset:  AIM; IM    
Bipolar and Psychotic Disorders Program, Mailman Research Center, McLean Hospital, Belmont, Mass.
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MeSH Terms
Akathisia, Drug-Induced / diagnosis,  etiology
Antidepressive Agents / adverse effects*,  therapeutic use
Antidepressive Agents, Tricyclic / adverse effects
Bipolar Disorder / chemically induced*,  diagnosis,  drug therapy*,  psychology
Bupropion / adverse effects
Delusions / chemically induced,  diagnosis
Diagnosis, Differential
Fluoxetine / adverse effects
Hallucinations / chemically induced,  diagnosis
Monoamine Oxidase Inhibitors / adverse effects
Psychomotor Agitation / diagnosis
Psychotic Disorders / drug therapy,  psychology
Retrospective Studies
Severity of Illness Index
Grant Support
Reg. No./Substance:
0/Antidepressive Agents; 0/Antidepressive Agents, Tricyclic; 0/Monoamine Oxidase Inhibitors; 34841-39-9/Bupropion; 54910-89-3/Fluoxetine

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