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Late-life Onset Mania After Varenicline Use: A Case Report
Abdullah Akpinar1, Gülin Özdamar Ünal1, İnci Meltem Atay1
1Süleyman Demirel University Faculty of Medicine, Department of Psychiatry, Isparta, Turkey.
Noro Psikiyatri Arsivi
|April 1, 2017
Summary
Varenicline, a smoking cessation aid, may trigger new-onset manic episodes in adults, even those without prior bipolar disorder. Close psychiatric monitoring during treatment is recommended.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Late-life onset manic attacks are often secondary to medical conditions or substance use.
- Varenicline is a partial agonist of the α4β2 nicotinic acetylcholine receptor, prescribed for smoking cessation.
Observation:
- A 67-year-old male developed a new-onset manic episode after initiating varenicline.
- Manic symptoms emerged on the seventh day of varenicline treatment and persisted after discontinuation.
- The patient's Young Mania Rating Scale (YMRS) score significantly improved upon hospitalization and treatment adjustment.
Findings:
- Varenicline use was associated with the induction of a manic episode in a patient without a prior psychiatric history.
- The case suggests varenicline can precipitate mania in both individuals with bipolar disorder and healthy subjects.
Implications:
- Varenicline may pose a risk for inducing manic episodes, necessitating careful consideration in patient selection.
- Pre-treatment and ongoing mental status examinations are crucial for patients undergoing varenicline therapy.
- This case highlights the importance of pharmacovigilance for psychiatric adverse events associated with smoking cessation medications.