Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria
We critically appraised all published reports of hypomania and mania following antidepressant termination. To increase reliability and validity we devised diagnostic criteria for an antidepressant discontinuation or withdrawal ‘manic state’ based primarily on the Diagnostic and Statistical Manual of...
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| Veröffentlicht in: | Journal of psychopharmacology (Oxford) 2011-03, Vol.25 (3), p.306-313 |
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| creator | Narayan, Vinesh Haddad, Peter M |
| description | We critically appraised all published reports of hypomania and mania following
antidepressant termination. To increase reliability and validity we devised
diagnostic criteria for an antidepressant discontinuation or withdrawal
‘manic state’ based primarily on the Diagnostic and Statistical
Manual of Mental Disorders, 4th edition substance withdrawal criteria. A
systematic literature review identified 24 reports meeting our criteria. Mean
age was 39 years (range 18–74), men and women were approximately equally
represented, and more cases involved people with unipolar
(n = 19) than bipolar disorder
(n = 4). The median duration of
preceding antidepressant treatment was 12 weeks (range 4 weeks–12
years). All major antidepressant classes were involved (tricyclic
antidepressants = 13; selective
serotonin reuptake inhibitors = 5;
monoamine oxidase inhibitors = 3;
selective serotonin-norepinephrine reuptake
inhibitors = 2;
miscellaneous = 1). More cases
followed abrupt antidepressant withdrawal
(n = 11) than a tapered withdrawal
(n = 6). Six cases appeared to meet
the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th
edition for a manic episode, with two cases requiring inpatient admission. Of
the 24 cases, nine resolved spontaneously without treatment (median
duration = 25.5 days), six
responded to antimanic drugs, four resolved following antidepressant
reinstatement, and treatment was unclear in five cases. We conclude that
antidepressant discontinuation hypomania/mania is a valid syndrome. It should be
added to the differential diagnosis of hypomania/mania. The clinical
implications and possible mechanisms are discussed. |
| doi_str_mv | 10.1177/0269881109359094 |
| format | Article |
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antidepressant termination. To increase reliability and validity we devised
diagnostic criteria for an antidepressant discontinuation or withdrawal
‘manic state’ based primarily on the Diagnostic and Statistical
Manual of Mental Disorders, 4th edition substance withdrawal criteria. A
systematic literature review identified 24 reports meeting our criteria. Mean
age was 39 years (range 18–74), men and women were approximately equally
represented, and more cases involved people with unipolar
(n = 19) than bipolar disorder
(n = 4). The median duration of
preceding antidepressant treatment was 12 weeks (range 4 weeks–12
years). All major antidepressant classes were involved (tricyclic
antidepressants = 13; selective
serotonin reuptake inhibitors = 5;
monoamine oxidase inhibitors = 3;
selective serotonin-norepinephrine reuptake
inhibitors = 2;
miscellaneous = 1). More cases
followed abrupt antidepressant withdrawal
(n = 11) than a tapered withdrawal
(n = 6). Six cases appeared to meet
the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th
edition for a manic episode, with two cases requiring inpatient admission. Of
the 24 cases, nine resolved spontaneously without treatment (median
duration = 25.5 days), six
responded to antimanic drugs, four resolved following antidepressant
reinstatement, and treatment was unclear in five cases. We conclude that
antidepressant discontinuation hypomania/mania is a valid syndrome. It should be
added to the differential diagnosis of hypomania/mania. The clinical
implications and possible mechanisms are discussed.</description><identifier>ISSN: 0269-8811</identifier><identifier>EISSN: 1461-7285</identifier><identifier>DOI: 10.1177/0269881109359094</identifier><identifier>PMID: 20156925</identifier><language>eng</language><publisher>UK: SAGE Publications</publisher><subject>Adolescent ; Adult ; Adult and adolescent clinical studies ; Affective disorders ; Age ; Aged ; Amine oxidase (flavin-containing) ; Antidepressants ; Antidepressive Agents - adverse effects ; Antidepressive Agents - pharmacology ; Antidepressive Agents - therapeutic use ; Antimanic Agents - therapeutic use ; Biological and medical sciences ; Bipolar disorder ; Bipolar Disorder - diagnosis ; Bipolar Disorder - etiology ; Bipolar Disorder - therapy ; Criteria ; Diagnosis, Differential ; Differential diagnosis ; Female ; Humans ; Inhibitors ; Literature reviews ; Male ; Mania ; Medical sciences ; Men ; Mental disorders ; Middle Aged ; Mood disorders ; Neuropharmacology ; Norepinephrine ; Pharmacology. Drug treatments ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychopharmacology ; Reinstatement ; Serotonin ; Serotonin uptake inhibitors ; Statistics ; Substance Withdrawal Syndrome - etiology ; Systematic review ; Time Factors ; Tricyclic antidepressants ; Young Adult</subject><ispartof>Journal of psychopharmacology (Oxford), 2011-03, Vol.25 (3), p.306-313</ispartof><rights>The Author(s) 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>2015 INIST-CNRS</rights><rights>The Author(s) 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-40be2102fa1bbfd6f2db4168e8ece0d5df1340448d1dd36fc00d6ad907fca70a3</citedby><cites>FETCH-LOGICAL-c426t-40be2102fa1bbfd6f2db4168e8ece0d5df1340448d1dd36fc00d6ad907fca70a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0269881109359094$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0269881109359094$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24198669$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20156925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Narayan, Vinesh</creatorcontrib><creatorcontrib>Haddad, Peter M</creatorcontrib><title>Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria</title><title>Journal of psychopharmacology (Oxford)</title><addtitle>J Psychopharmacol</addtitle><description>We critically appraised all published reports of hypomania and mania following
antidepressant termination. To increase reliability and validity we devised
diagnostic criteria for an antidepressant discontinuation or withdrawal
‘manic state’ based primarily on the Diagnostic and Statistical
Manual of Mental Disorders, 4th edition substance withdrawal criteria. A
systematic literature review identified 24 reports meeting our criteria. Mean
age was 39 years (range 18–74), men and women were approximately equally
represented, and more cases involved people with unipolar
(n = 19) than bipolar disorder
(n = 4). The median duration of
preceding antidepressant treatment was 12 weeks (range 4 weeks–12
years). All major antidepressant classes were involved (tricyclic
antidepressants = 13; selective
serotonin reuptake inhibitors = 5;
monoamine oxidase inhibitors = 3;
selective serotonin-norepinephrine reuptake
inhibitors = 2;
miscellaneous = 1). More cases
followed abrupt antidepressant withdrawal
(n = 11) than a tapered withdrawal
(n = 6). Six cases appeared to meet
the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th
edition for a manic episode, with two cases requiring inpatient admission. Of
the 24 cases, nine resolved spontaneously without treatment (median
duration = 25.5 days), six
responded to antimanic drugs, four resolved following antidepressant
reinstatement, and treatment was unclear in five cases. We conclude that
antidepressant discontinuation hypomania/mania is a valid syndrome. It should be
added to the differential diagnosis of hypomania/mania. The clinical
implications and possible mechanisms are discussed.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Affective disorders</subject><subject>Age</subject><subject>Aged</subject><subject>Amine oxidase (flavin-containing)</subject><subject>Antidepressants</subject><subject>Antidepressive Agents - adverse effects</subject><subject>Antidepressive Agents - pharmacology</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Antimanic Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bipolar disorder</subject><subject>Bipolar Disorder - diagnosis</subject><subject>Bipolar Disorder - etiology</subject><subject>Bipolar Disorder - therapy</subject><subject>Criteria</subject><subject>Diagnosis, Differential</subject><subject>Differential diagnosis</subject><subject>Female</subject><subject>Humans</subject><subject>Inhibitors</subject><subject>Literature reviews</subject><subject>Male</subject><subject>Mania</subject><subject>Medical sciences</subject><subject>Men</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Mood disorders</subject><subject>Neuropharmacology</subject><subject>Norepinephrine</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Reinstatement</subject><subject>Serotonin</subject><subject>Serotonin uptake inhibitors</subject><subject>Statistics</subject><subject>Substance Withdrawal Syndrome - etiology</subject><subject>Systematic review</subject><subject>Time Factors</subject><subject>Tricyclic antidepressants</subject><subject>Young Adult</subject><issn>0269-8811</issn><issn>1461-7285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2LFDEQxYMo7uzq3ZMERPbUWkmn0x1vy-IXLHjRc1OdVMYsPekxSSv-92ac8YMF8RRI_d7LqzzGngh4IUTfvwSpzTAIAabtDBh1j22E0qLp5dDdZ5vDuDnMz9h5zrcAQivdPWRnEkSnjew2LF3FEhztE-WMsXAXsl3qVVyxhCXyHcZgeS5YKL_iyG0KJViceaKvgb7xxfPymfgcCiUsayKO0fG8breUC7nqh9u45Kr5KaUU8BF74HHO9Ph0XrBPb15_vH7X3Hx4-_766qaxSurSKJhICpAexTR5p710kxJ6oIEsgeucF60CpQYnnGu1twBOozPQe4s9YHvBLo---7R8WWuccVeXo3nGSMuax0qKDkD2_yWHTrW96YWp5LM75O2ypljXGIUBJZXuVVcpOFI2LTkn8uM-hR2m76OA8VDceLe4Knl6Ml6nHbnfgl9NVeD5CcBc_98njDbkP5wSZtD6kLA5chm39Fe6fz38AyrJrq4</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>Narayan, Vinesh</creator><creator>Haddad, Peter M</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20110301</creationdate><title>Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria</title><author>Narayan, Vinesh ; Haddad, Peter M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-40be2102fa1bbfd6f2db4168e8ece0d5df1340448d1dd36fc00d6ad907fca70a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Affective disorders</topic><topic>Age</topic><topic>Aged</topic><topic>Amine oxidase (flavin-containing)</topic><topic>Antidepressants</topic><topic>Antidepressive Agents - adverse effects</topic><topic>Antidepressive Agents - pharmacology</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Antimanic Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bipolar disorder</topic><topic>Bipolar Disorder - diagnosis</topic><topic>Bipolar Disorder - etiology</topic><topic>Bipolar Disorder - therapy</topic><topic>Criteria</topic><topic>Diagnosis, Differential</topic><topic>Differential diagnosis</topic><topic>Female</topic><topic>Humans</topic><topic>Inhibitors</topic><topic>Literature reviews</topic><topic>Male</topic><topic>Mania</topic><topic>Medical sciences</topic><topic>Men</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Mood disorders</topic><topic>Neuropharmacology</topic><topic>Norepinephrine</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Reinstatement</topic><topic>Serotonin</topic><topic>Serotonin uptake inhibitors</topic><topic>Statistics</topic><topic>Substance Withdrawal Syndrome - etiology</topic><topic>Systematic review</topic><topic>Time Factors</topic><topic>Tricyclic antidepressants</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Narayan, Vinesh</creatorcontrib><creatorcontrib>Haddad, Peter M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of psychopharmacology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Narayan, Vinesh</au><au>Haddad, Peter M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria</atitle><jtitle>Journal of psychopharmacology (Oxford)</jtitle><addtitle>J Psychopharmacol</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>25</volume><issue>3</issue><spage>306</spage><epage>313</epage><pages>306-313</pages><issn>0269-8811</issn><eissn>1461-7285</eissn><abstract>We critically appraised all published reports of hypomania and mania following
antidepressant termination. To increase reliability and validity we devised
diagnostic criteria for an antidepressant discontinuation or withdrawal
‘manic state’ based primarily on the Diagnostic and Statistical
Manual of Mental Disorders, 4th edition substance withdrawal criteria. A
systematic literature review identified 24 reports meeting our criteria. Mean
age was 39 years (range 18–74), men and women were approximately equally
represented, and more cases involved people with unipolar
(n = 19) than bipolar disorder
(n = 4). The median duration of
preceding antidepressant treatment was 12 weeks (range 4 weeks–12
years). All major antidepressant classes were involved (tricyclic
antidepressants = 13; selective
serotonin reuptake inhibitors = 5;
monoamine oxidase inhibitors = 3;
selective serotonin-norepinephrine reuptake
inhibitors = 2;
miscellaneous = 1). More cases
followed abrupt antidepressant withdrawal
(n = 11) than a tapered withdrawal
(n = 6). Six cases appeared to meet
the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th
edition for a manic episode, with two cases requiring inpatient admission. Of
the 24 cases, nine resolved spontaneously without treatment (median
duration = 25.5 days), six
responded to antimanic drugs, four resolved following antidepressant
reinstatement, and treatment was unclear in five cases. We conclude that
antidepressant discontinuation hypomania/mania is a valid syndrome. It should be
added to the differential diagnosis of hypomania/mania. The clinical
implications and possible mechanisms are discussed.</abstract><cop>UK</cop><pub>SAGE Publications</pub><pmid>20156925</pmid><doi>10.1177/0269881109359094</doi><tpages>8</tpages></addata></record> |
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| language | eng |
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| source | Access via SAGE; MEDLINE |
| subjects | Adolescent Adult Adult and adolescent clinical studies Affective disorders Age Aged Amine oxidase (flavin-containing) Antidepressants Antidepressive Agents - adverse effects Antidepressive Agents - pharmacology Antidepressive Agents - therapeutic use Antimanic Agents - therapeutic use Biological and medical sciences Bipolar disorder Bipolar Disorder - diagnosis Bipolar Disorder - etiology Bipolar Disorder - therapy Criteria Diagnosis, Differential Differential diagnosis Female Humans Inhibitors Literature reviews Male Mania Medical sciences Men Mental disorders Middle Aged Mood disorders Neuropharmacology Norepinephrine Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Reinstatement Serotonin Serotonin uptake inhibitors Statistics Substance Withdrawal Syndrome - etiology Systematic review Time Factors Tricyclic antidepressants Young Adult |
| title | Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria |
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