Antidepressant-discontinuation Mania in Two Patients with Depression

Vortioxetine Induced Hypomania: A Case Presentation and Review of the Literature

Antidepressant-induced hypomania/mania is a complex issue that can be seen in mood disorders but is not clarified. There are case reports in the literature regarding vortioxetine-induced mania and hypomania; however, there is insufficient data. Here, we aim to present a case of vortioxetine-induced hypomania in a major depressive disorder patient who previously used various antidepressants but did not experience hypomania or mania. Our case is expected to contribute to the literature.

A Review of Antidepressant-Associated Hypomania in Those Diagnosed with Unipolar Depression-Risk Factors, Conceptual Models, and Management

PURPOSE OF REVIEW

The nosology and management of antidepressant-associated hypomania (AAH) in the treatment of unipolar depression requires clarification. We sought to review recent studies examining AAH, focusing on risk factors, differing explanatory models, and management strategies.

RECENT FINDINGS

AAH occurs more frequently in those of female gender, younger age, and with a bipolar disorder (BP) family history. Depressive features (e.g., suicidal ideation, psychotic symptoms) in those with AAH were similar to those with established BPs. Explanatory models for AAH describe it as (i) a transient iatrogenic event, (ii) a specific "bipolar III" disorder, (iii) indicative of "conversion" to BP, (iv) acceleration of BP, and (v) coincidental and unrelated to antidepressant medication. Management recommendations include antidepressant cessation, atypical antipsychotic medications, or switching to a mood stabilizer. Determinants and management of AAH in the treatment of unipolar depression requires considerable clarification, likely to be achieved by close clinical review and refined research studies.