Abstract
BackgroundDepressive disorders are common among those with bipolar affective disorder (BAD) and may necessitate the use of antidepressants. This has been suggested to precipitate manic episodes in some patients.ObjectivesThis study aims to determine the prevalence of and factors associated with manic switch in patients with BAD being treated with antidepressants.MethodsCase notes of patients who were treated at a Nigerian neuropsychiatric hospital for a BAD from 2004 to 2015 were reviewed. BAD diagnosis was made using ICD-10 criteria. Treatment for bipolar depression included monotherapy (i.e. antidepressants, antipsychotics or mood stabilisers) or combination therapy (mood stabiliser with an antidepressant or a combination of mood stabilisers, antipsychotics and antidepressants). The primary outcome measure was a switch to mania or hypomania within 12 weeks of commencing an antidepressant.ResultsManic or hypomanic switch (MS) was observed in 109 (44.3%) of the participants. Female gender, younger age, number of previous episodes and a past history of psychiatric hospitalisation were all significantly associated with a risk of MS. There was no significant difference in the rate of MS in either those treated with adjunct antidepressants therapy with a mood stabiliser or an antipsychotic or those placed on a combination of antidepressants, antipsychotics and mood-stabilising agents.ConclusionA large proportion of patients with BAD on antidepressants experience medication-induced manic or hypomanic switch.
Highlights
Bipolar affective disorder (BAD) is a chronic debilitating illness with an estimated lifetime prevalence of 0.1% – 7.5%.1 The disorder is characterised by manic episodes or hypomanic episodes interspersed with depressive episodes.[2]
Existing reports suggest that the propensity of a manic switch by antidepressants is higher for the tricyclic antidepressants (TCAs) compared to the second-generation antidepressants (SGA),[12,20,21,22] this may have been confounded by sparse data on these classes of antidepressants compared to the TCAs.[23]
Twenty cases were discarded on account of incomplete data or doubtful diagnosis; 246 cases were included in the analysis
Summary
Bipolar affective disorder (BAD) is a chronic debilitating illness with an estimated lifetime prevalence of 0.1% – 7.5%.1 The disorder is characterised by manic episodes or hypomanic episodes interspersed with depressive episodes.[2]. Depressive disorders are common among those with bipolar affective disorder (BAD) and may necessitate the use of antidepressants. This has been suggested to precipitate manic episodes in some patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
