Is antidepressant-associated mania always an evidence of a bipolar spectrum disorder? A case report and review of the literature.
OBJECTIVE
The authors consider the clinical implications of characterizing every case of antidepressant-induced mania as evidence of an underlying bipolar diathesis.


METHODS
The authors report the case of a 45-year-old man, with no personal or family history of bipolar symptoms, who developed manic symptoms after sertraline initiation for a first lifetime depressive episode.


RESULTS
The patient's manic symptoms resolved rapidly with cessation of sertraline. His depressive symptoms responded to mirtazapine, and he had no further mood episodes during 2-year follow-up.


CONCLUSIONS
It may not always be appropriate to identify selective serotonin reuptake inhibitor-induced manic symptoms as pathognomonic for the bipolar diathesis, particularly as the bipolar formulation has distinct implications for future pharmacologic choices.
Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356073, Seattle, WA 98195-6073, USA. Electronic address: rjkimmel@uw.edu.
Ryan J
RJ
Kimmel
Jenny
J
Seibert
D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D020280:Sertraline / Q000009:adverse effects
D000928:Antidepressive Agents; D008803:Mianserin; D000078785:Mirtazapine; D020280:Sertraline
Bipolar disorder; Pharmacology