Drug-induced mania
by
Peet M, Peters ST
University Department of Psychiatry,
Northern General Hospital, Sheffield,
England.
Drug Saf 1995 Feb; 12(2):146-53
ABSTRACT
Mania can occur by chance association during drug treatment, particularly in
patients predisposed to mood disorder. Single case reports are unreliable, and
evidence must be sought from large series of treated patients, particularly
those with a matched control group. Drugs with a definite propensity to cause
manic symptoms include levodopa, corticosteroids and anabolic-androgenic
steroids. Antidepressants of the tricyclic and monoamine oxidase inhibitor
classes can induce mania in patients with pre-existing bipolar affective
disorder. Drugs which are probably capable of inducing mania, but for which the
evidence is less scientifically secure, include other dopaminergic
anti-Parkinsonian drugs, thyroxine, iproniazid and isoniazid, sympathomimetic
drugs, chloroquine, baclofen, alprazolam, captopril, amphetamine and
phencyclidine. Other drugs may induce mania rarely and idiosyncratically.
Management involves discontinuation or dosage reduction of the suspected drug,
if this is medically possible, and treatment of manic symptoms with
antipsychotic drugs or lithium.
Mania
Levodopa
Thyroxine
Alprazolam
Phencyclidine
Corticosteroids
Bipolar disorders
Parkinson's disease
The manic spectrum
DHEA-induced mania
Bipolar polypharmacy
Drug-induced depression
Antidepressant-induced mania
Which antidepressants flick the switch?
Angiotensin-converting enzyme inhibitors
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