Abstract
ABSTRACTCaseA woman in her early 40s with bipolar disorder had panic disorder. She had to avoid selective serotonin reuptake inhibitors (SSRIs), the standard medication for panic disorder, which could cause a switch to mania in bipolar disorder.OutcomeThe attacks decreased without a switch to mania after she started taking hangekobokuto (banxia‐houpo‐tang). Hangekobokuto is reported to increase serotonin in the brain. According to another report, hangekobokuto reduced c‐fos expression, a marker of neuronal activity in the hippocampus only in the animal model of depression, while SSRIs reduced it in both depressive and control animals. This suggests that, unlike SSRIs, hangekobokuto may not have unnecessary effects which might induce elated mood in non‐depressive cases. Therefore, hangekobokuto might be safer than SSRIs for non‐depressive biplolar patients like this patient.ConclusionHangekobokuto could be one of the options to treat panic disorder in patients with bipolar disorder, although further study is necessary.
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