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[Manic episodes during antidepressant treatment in bipolar disorder]
1Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. São Paulo, SP, Brasil. rstamada@uol.com.br
Objectives:
To review the literature on antidepressant-induced mania, its incidence, clinical presentation, risk factors and treatment.
Methods:
A Medline search of studies published between 1970 and 2001 was carried out. Open and controlled studies as well as case series with data from more than five patients were included.
Results:
Antidepressant induced mania may differ clinically from spontaneous mania with a milder severity and shorter duration. The risk factors have not been established.
Conclusion:
A very limited number of prospective and controlled studies on antidepressant-induced mania have been published. Antidepressants have been associated with an increased risk of inducing mania. This risk may vary according to the drug utilized. Therefore antidepressants should be used in bipolar patients based on clinical efficacy as well as the potential effects on the course of the illness.