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Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria

FORUM FOR PSYCHIATRY RESIDENTS :: Psychiatry :: Psychiatry-Neurology-Psychology discussion :: Psycho-Pharmacology

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Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria Empty Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria

Post  Admin Sat Jun 18, 2011 6:53 am

Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria


We critically appraised all published reports of hypomania and mania following antidepressant termination. To increase reliability and validity we devised diagnostic criteria for an antidepressant discontinuation or withdrawal ‘manic state’ based primarily on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition substance withdrawal criteria.
A systematic literature review identified 24 reports meeting our criteria. More cases followed abrupt antidepressant withdrawal (n = 11) than a tapered withdrawal (n = 6).
6 cases appeared to meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition for a manic episode, with two cases requiring inpatient admission. Of the 24 cases, 9 resolved spontaneously without treatment (median duration = 25.5 days), 6 responded to antimanic drugs, 4 resolved following antidepressant reinstatement, and treatment was unclear in 5 cases.

We conclude that antidepressant discontinuation hypomania/mania is a valid syndrome. It should be added to the differential diagnosis of hypomania/mania.

Source: J Psychopharmacol.
Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria Col2-310
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