Tardive dyskinesia (TD) usually appears after years of antipsychotic drug use and appears to be related to the total lifetime medication dose. In withdrawal-emergent dyskinesia (WE-D), which is considered to be a subtype of TD, dyskinetic symptoms often appear shortly after a rapid reduction in antipsychotic drug dose or sudden discontinuation of the drug. Supersensitivity psychosis, which is frequently observed along with TD and is considered to have a similar etiology as TD, is a psychotic relapse phenomenon that occurs after the withdrawal of an antipsychotic drug or a rapid reduction in the drug dosage. In general, atypical antipsychotics tend to be associated with less propensity to cause TD when compared with typical antipsychotics. Furthermore, olanzapine and clozapine may have a therapeutic potential in improving or totally curing TD. In this study, a case of WE-D because of discontinuing olanzapine use and supersensitivity psychosis is discussed.
IntroductionDespite its controversial history, electroconvulsive therapy is generally an effective treatment with few serious side effects. One rare but troublesome side effect of electroconvulsive therapy is mania.Case presentationA 33-year-old Turkish woman developed mania on three separate occasions after receiving electroconvulsive therapy for severe depressive episodes.ConclusionPatients who experience electroconvulsive therapy-related mania should be evaluated for alternative treatments when presenting with severe depression.
Mania/hypomania associated with withdrawal of antidepressants Although paradoxical mania/hypomania due to antidepressant withdrawal is rarely reported in the literature as case report, it is possible that it may be observed more commonly in the clinical settings. Paradoxical mania/hypomania is reported to be associated with tricyclic antidepressants as well as selective serotonin reuptake inhibitors and other antidepressants. Although paradoxical mania/hypomania due to sertraline and paroxetine withdrawal are reported individually, we will discuss a patient with paradoxical mania/ hypomania due to withdrawal of both antidepressants administered at two different time periods, since this is the only case reported so far.Key words: Antidepressant withdrawal, hypomania, mania, paroxetine, sertraline ÖZET Antidepresan kesilmesine bağlı mani/hipomani Antidepresan kesilmesi sonrası "paradoksal" mani/hipomani, literatürde az sayıda olgu bildirimi şeklinde yer almakla birlikte, klinikte daha sık karşılaşılıyor olması muhtemeldir. Sıklıkla trisiklik antidepresanlarla (TSA) bildirilmiş olup, selektif serotonin geri alım inhibitörleri (SSGİ) ve daha nadir olarak diğer antidepresanlarla da bildirilmiştir. Sertralin ve paroksetin kesilmesine bağlı bildirilmiş olgular olmakla birlikte, aynı hastada farklı dönemlerde hem sertralin hem de paroksetin kesilmesine bağlı gelişen manik dönem olarak literatürdeki bilinen tek örnek olması açısından ilginç olduğunu düşündüğümüz bir olgu tartışılmıştır.
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