title: Atypical antipsychotic-induced mania/hypomania: a review of recent case reports and clinical studies.
abstract: OBJECTIVE
  Numerous case reports (53 between 1994 and 2003) caused concern with manic/hypomanic symptoms induced by atypical antipsychotic (AA) drugs. Its clinical relevance and causal link with AA antidepressant properties are largely unknown.
  
  
  METHODS
  We reviewed newly reported cases and clinical studies of AA-induced mania/hypomania between 2004 and 2010 in order to assess its prevalence and relation with mood disorders. Published studies were found through systematic database search (PubMed, Scirus, EMBASE, Cochrane Library, Science Direct).
  
  
  RESULTS
  Our search disclosed 28 new cases of AA-induced manic or hypomanic symptoms, following treatment with olanzapine (seven cases), quetiapine (five cases), ziprasidone (five cases), aripiprazole (four cases), amisulpride (two cases), zotepine (two cases), perospirone (two cases) and paliperidone (one case). Twenty-four patients suffered from schizophrenia; only four had schizoaffective disorder. Only one of the five cases of mania/hypomania with ziprasidone was a patient with mood disorder. Four well-designed clinical trials in bipolar depression included AA-induced mania/hypomania as a secondary outcome (three with quetiapine and one with olanzapine) and showed non-superiority relative to placebo.
  
  
  CONCLUSIONS
  Thus, well-designed clinical trials suggest that AA-induced mania/hypomania is a marginal phenomenon. Moreover, in most of the 28 new reported cases, AAs do not seem to induce mania/hypomania via their antidepressant properties.
authors: INSERM U669, Universit Paris-Sud UMR-SO669, AP-HP Paul Brousse University Hospital, Centre for Training, Research and Treatment in Addiction, 94804 Villejuif. amine.benyamina@pbr.aphp.fr
authors: Amine
authors: A
authors: Benyamina
authors: Ludovic
authors: L
authors: Samalin
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000453:epidemiology; D002986:Clinical Trials as Topic; D016206:Databases, Bibliographic; D006801:Humans; D019964:Mood Disorders / Q000453:epidemiology; D010919:Placebos; D015995:Prevalence; D011618:Psychotic Disorders / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D010919:Placebos