Endoxifen in Bipolar Disorder With Hyperammonemia and Renal Impairment: A Case Report

Lithium, divalproex, and oxcarbazepine are commonly prescribed medications used for the management of bipolar disorder, but each of these drugs comes with its own gamut of adverse effects that make these agents unfavorable in certain medical conditions. Endoxifen, a protein kinase C inhibitor and selective estrogen receptor modulator, originally used in breast cancer treatment, has recently emerged as a potential therapeutic option for managing manic episodes in bipolar disorder. This case report highlights the use of endoxifen in the management of severe manic symptoms of bipolar disorder in a 65-year-old male patient with medical comorbidities arising from traditional mood stabilizer drugs and its potential as an alternative treatment over such drugs.