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Multifocal leucoencephalopathy presenting as antidepressant induced mania
S S Damodaran1, V K Sinha, A Das
1S. Damodaran, MD, DPM, DNB, Senior Resident, Central Institute of Psychiatry, Kanke, Ranchi-6.
Indian Journal of Psychiatry
|July 12, 2011
Summary
Tricyclic antidepressants may induce hypomania in patients with chronic depression, potentially leading to dementia and multifocal leucoencephalopathy. Thorough investigation for Axis III diagnoses in chronic depression is recommended.
Area of Science:
- Neuroscience
- Psychiatry
- Neurology
Background:
- Tricyclic antidepressants (TCAs) are commonly used for chronic depression.
- Antidepressant-induced mood disturbances can occur.
- The relationship between brain lesions and affective disorders requires further investigation.
Purpose of the Study:
- To report a case of tricyclic-induced hypomania progressing to dementia with multifocal leucoencephalopathy.
- To discuss the potential role of brain lesions in affective syndromes.
- To explore the neurobiological hypothesis of bipolar disorders.
Main Methods:
- Case report presentation.
- Literature review on affective syndromes and neurobiology of bipolar disorders.
- Discussion of potential diagnostic considerations.
Main Results:
- A male patient developed hypomania after TCA treatment for chronic depression.
- The patient's condition deteriorated to dementia with evidence of multifocal leucoencephalopathy.
- The case highlights a potential link between TCAs, affective syndromes, and neurological deterioration.
Conclusions:
- Chronic depression may warrant investigation for underlying Axis III (physical) diagnoses.
- Brain lesions could play a role in the development of affective syndromes.
- Further research into the neurobiological underpinnings of bipolar syndromes is needed.
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