Corticosteroids and mania: A systematic review

De Bock, Mathias; Sienaert, Pascal

doi:10.1080/15622975.2024.2312572

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2024

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“…Co-occurring substance abuse further complicates the diagnosis. The bipolar switch might arise due to spontaneous or iatrogenic causes [ 2 ]; a variety of medications have been implicated in “treatment-emergent affective switch,” including all major antidepressant classes [ 3 ], stimulants [ 4 ], corticosteroids [ 5 ], and thyroid hormones [ 6 ]. Bipolar patients not on a mood stabilizer are particularly susceptible to treatment-emergent affective switch.…”

Section: Introductionmentioning

confidence: 99%

The Emergence of Mania After Initiating Escitalopram for Anxiety Disorder

Surineni,

Armstrong,

Wallace

et al. 2024

Cureus

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The abrupt transition into mania, known as a bipolar switch, poses a significant challenge in the treatment of mental illnesses. We present a case of a 22-year-old Hispanic female with generalized anxiety disorder (GAD) and autism spectrum disorder (ASD) who developed mania within five days after initiating escitalopram 5 mg. The patient had no reported history of bipolar disorder prior to this episode, and an extensive medical workup ruled out organic causes. The patient was in the acute inpatient psychiatric unit for 25 days and returned to baseline after discontinuation of escitalopram and initiating divalproex and olanzapine. This case underscores the potential risk of a bipolar switch with antidepressant use and highlights the importance of vigilant monitoring and considering underlying bipolarity in such patients.

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