title: Abuse of dosulepin to induce mania.
abstract: BACKGROUND
  Tricyclic antidepressants sometimes trigger mania in bipolar patients, but little is known about their potential for abuse in this regard.
  
  
  METHODS
  We describe a man with bipolar disorder and alcohol dependency who abused dosulepin repeatedly in order to induce manic episodes. This caused serious problems for treatment and long-term outcome. We mention two further cases in which dosulepin or clomipramine was used deliberately to induce bipolar mania.
  
  
  CONCLUSIONS
  Tricyclic antidepressants can be abused to induce mood elevation in bipolar patients. This should be considered in cases of treatment-resistant mania.
authors.affiliation: North Wales Section of of Psychological Medicine, University of Wales Academic Unit, Wrexham, Wales. peter.lepping@new-tr.wales.nhs.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Lepping
authors.forename: David B
authors.initials: DB
authors.lastname: Menkes
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000150:complications; D004308:Dothiepin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D012653:Self Stimulation / Q000187:drug effects*; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D000929:Antidepressive Agents, Tricyclic; D004308:Dothiepin