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Related Experiment Videos

Age effects on antidepressant-induced manic conversion.

Andrés Martin1, Christopher Young, James F Leckman

  • 1Child Study Center, the Department of Psychiatry, Yale University School of Medicine, New Haven, CN 06520-7900, USA. Andres.Martin@Yale.Edu

Archives of Pediatrics & Adolescent Medicine
|August 4, 2004
PubMed
Summary

Antidepressant use increases mania risk, especially in peripubertal children aged 10-14. This study highlights age as a key factor in antidepressant-associated manic conversion, with younger individuals facing higher risks.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Epidemiology

Background:

  • Antidepressant therapy can trigger mania in susceptible individuals.
  • The influence of patient age on this phenomenon is not well understood.

Purpose of the Study:

  • To conduct a pharmacoepidemiological evaluation of manic conversion risk.
  • To assess how antidepressant class and patient age affect this risk.

Main Methods:

  • Analysis of linked outpatient and pharmacy claims from a large national database (over 7 million individuals).
  • Study population included 87,920 mental health users aged 5 to 29 years.
  • Cox proportional hazards models were used to analyze manic conversion (defined as new bipolar illness diagnosis) by antidepressant class and age group.

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Main Results:

  • Overall, 5.4% of patients experienced manic conversion.
  • Antidepressant use was associated with increased risk (HRs: 2.1 for SSRIs, 3.8 for "other", 3.9 for TCAs).
  • Inverse age effects were observed for SSRIs and "other" antidepressants, with the highest risk in 10- to 14-year-olds (NNH=10).

Conclusions:

  • Patient age significantly modifies the risk of antidepressant-associated manic conversion.
  • Antidepressant treatment poses the highest risk of conversion to mania in children aged 10 to 14 years.