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Mania associated with codeine and paracetamol

K G Orr1, J Mostert, D J Castle

  • 1Armadale Clinic, Perth, Australia.

The Australian and New Zealand Journal of Psychiatry
|August 26, 1998
PubMed
Summary
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Panadeine Forte, containing codeine and paracetamol, can trigger manic episodes in susceptible individuals. Discontinuation of the medication led to a full recovery within a week.

Area of Science:

  • Pharmacology
  • Psychiatry
  • Neuroscience

Background:

  • Opioid analgesics, such as codeine, are widely available.
  • Paracetamol is a common over-the-counter pain reliever.
  • Codeine and paracetamol are combined in Panadeine Forte.

Observation:

  • A patient presented with a manic psychotic episode.
  • The episode was linked to the use of Panadeine Forte.
  • Symptoms resolved after discontinuing the medication and initiating antipsychotic treatment.

Findings:

  • High doses of Panadeine Forte can induce mania.
  • Individuals with a biological predisposition may be more susceptible.
  • Complete recovery was observed within one week of treatment cessation.

Related Experiment Videos

Implications:

  • Clinicians should consider medication-induced mania in differential diagnoses.
  • Awareness of potential psychiatric side effects of codeine-containing analgesics is crucial.
  • Further research into the neurobiological mechanisms underlying codeine-induced mania is warranted.