title: Suspected antidepressant-induced switch to mania in unipolar depression: a first-person narrative.
abstract: BACKGROUND
  Antidepressant-induced switch to mania has not been thoroughly characterized in bipolar disorder and is even less well understood in unipolar depression.
  
  
  RESULTS
  I describe, as a first-person narrative, my own experience of psychotic mania, which was suspected to have been induced by the tricyclic antidepressant, dosulepin. I have had a 16-year history of depression and was receiving sertraline 50 mg od when I was prescribed, off licence, dosulepin 25 mg 1-2 nocte for insomnia. Within days, I developed mild hypomanic symptoms and returned to my GP, who discontinued dosulepin but continued treatment with sertraline. I was also referred for psychiatric assessment. Two months later, I was detained under Section II of the Mental Health Act 1983 and admitted to hospital with psychotic manic symptoms.
  
  
  CONCLUSIONS
  More understanding of antidepressant-induced switch to mania is needed in unipolar depression. My case study highlights the need for prompt specialist care for patients with depression reporting even mild, sub-threshold symptoms of mania.
authors.affiliation: catherine@redgraphite.co.uk
authors.forename: C
authors.initials: C
authors.lastname: Amey
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000627:therapeutic use; D053961:Azabicyclo Compounds / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D003134:Commitment of Persons with Psychiatric Disorders; D004308:Dothiepin / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D011939:Mental Recall; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000523:psychology; D020280:Sertraline / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone; D020280:Sertraline; D004308:Dothiepin