Abstract

Introduction: Antidepressants have been associated with the induction of hypomania and mania. Objective: to actualise the concept of pharmacological switch to hypomania and its relevance in bipolar type III depression. Methodology: Medline search using the key words antidepressives, pharmacological switch, type III bipolarity. Results: The antidepressant associated mania occurs more frequently in bipolar depression, the use of tricyclic antidepressants and the duration of treatment. Conclusions: Unipolar patients who switch to a bipolar illness with the use of antidepressants, and who have not developed a bipolar phase spontaneously before are called pseudo-unipolar and are classified within the spectrum of type III bipolar disorder. Pharmalogical switch is the best predictor for the development of bipolar illness with a 100% specificity.

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