Antidepressant-induced mania in obsessive compulsive disorder.

Area of Science:

• Psychiatry
• Neuroscience
• Pharmacology

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are primary treatments for obsessive compulsive disorder (OCD).
• Comorbid depression is common in OCD patients.
• Antidepressants carry a risk of treatment-emergent affective switch.

Purpose of the Study:

• To report a case of treatment-emergent mania in a patient with OCD on long-term antidepressant therapy.
• To highlight the management of affective switch in a complex psychiatric case.

Main Methods:

• Case report of a 48-year-old female patient with a history of OCD and depression.
• Review of psychopharmacological treatment history, including SSRIs and subsequent mood stabilizers.
• Clinical observation of treatment response to olanzapine and divalproex sodium.

Main Results:

• The patient developed mania after two decades of antidepressant treatment.
• The manic episode showed a positive response to olanzapine and divalproex sodium.
• This case illustrates a rare but significant adverse effect of long-term antidepressant use.

Conclusions:

• Long-term antidepressant therapy in OCD patients can precipitate affective switch, including mania.
• Mood stabilizers like olanzapine and divalproex sodium can effectively manage antidepressant-induced mania.
• Careful monitoring for affective switch is crucial in patients with OCD on long-term antidepressant treatment.