Antidepressant-induced rapid cycling: six case reports.
We report six cases of rapid mood cycling induced by antidepressant treatment. The key to effective treatment involved the recognition of the pattern of apparent remission, relapse, antidepressant and/or stimulant adjustment, remission, relapse, etc. Hypomanic episodes were frequently mild and could be mistaken for remission. The destabilizing effects of antidepressant drugs were not corrected by the addition of mood stabilizers, necessitating the withdrawal of the antidepressant agent. All but one case responded to such withdrawal. Two cases required the addition of high-dose L-thyroxine for stabilization. Implications for an effective treatment protocol are discussed.
Hurowitz
G I
GI
Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
Liebowitz
M R
MR
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000188:drug therapy* / Q000523:psychology; D003866:Depressive Disorder / Q000139:chemically induced* / Q000188:drug therapy / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010507:Periodicity; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000523:psychology
D000928:Antidepressive Agents