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Lurasidone-Induced Manic Switch in an Adolescent with Bipolar I Disorder: a Case Report
S S Nair1, C J M Chua2, D C L Teo1
1Department of Psychological Medicine, Changi General Hospital, Singapore.
Summary
Lurasidone can trigger manic episodes in adolescents with bipolar depression, even when combined with other medications. This case report emphasizes the need for careful monitoring in this patient population.
Area of Science:
- Psychiatry
- Adolescent mental health
- Pharmacovigilance
Background:
- Lurasidone is a common treatment for bipolar depression in adults and adolescents.
- Manic switch is a known risk associated with lurasidone in adults, but has not been previously documented in adolescents.
- Bipolar I depression requires careful medication management to avoid mood destabilization.
Observation:
- A male adolescent diagnosed with bipolar I depression was treated with sodium valproate and olanzapine.
- Lurasidone was added to the patient's medication regimen.
- Within five days of adding lurasidone, the adolescent exhibited manic symptoms, including psychotic features.
Findings:
- The patient experienced a manic switch, characterized by psychosis, shortly after initiating lurasidone.
- Discontinuation of lurasidone led to stabilization of manic symptoms.
- Electroconvulsive therapy (ECT) was used to manage the acute manic episode.
Implications:
- This case suggests that lurasidone may pose a risk of inducing manic switch in adolescent patients with bipolar depression.
- Clinicians should exercise caution and closely monitor adolescents for signs of mania when prescribing lurasidone.
- Further research is warranted to understand the prevalence and risk factors for lurasidone-induced manic switch in pediatric populations.
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