Antidepressant-Induced Mania in Nonbipolar Adult Patients

Antidepressant-Induced Mania in Nonbipolar Adult Patients 

The following studies make clear that the newer antidepressants very commonly cause mania. Too many prescribing health care providers seem oblivious to this risk or explain it away as an unmasking of an underlying mania, a rationalization that has no scientific justification. 

The initial euphoria associated with mild cases of drug-induced mania often offer relief and hope, however unrealistic, to the patients who experience it. If the euphoria does not progress to full-blown mania, it is likely to wear off, and then apathy becomes more dominant over time. This often leads patients to ask for one antidepressant after another in the hope of recapturing that brief high.  

Some of the most tragic medical-legal cases I have evaluated began with the patient in effect telling the doctor shortly after starting the medication, I ve never felt better in my life. Too often this signals the start of a drug-induced manic reaction, technically called a substance-induced mood disorder with manic features. 

Martin et al. (2004) used an administrative national database of more than 7 million privately insured individuals, aged 5-29 years, to find new diagnoses of bipolar illness made in association with antidepressant treatment. They found a statistically significant correlation between exposure to all categories of antidepressants and the subsequent diagnosis of bipolar disorder. During a median follow-up of 41 weeks, manic conversion occurred in 5.4% of patients. The highest risk was 

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