Mania Associated with Mirtazepine Treatment and Mixed Depression

Habermeyer, Benedikt; Bayer, U.; Müller‐Spahn, F.

doi:10.1055/s-0029-1239591

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Differenzialdiagnostisch könnte vor dem Hintergrund der erhöhten Dopaminfreisetzung auch ein manischer, paranoidhalluzinatorischer Switch als Folge der Mirtazapineinnahme in Frage kommen. In Einzelfallberichten ist eine Induktion von manischen Symptomen nach Einnahme von schlaffördernden Antidepressiva wie Mirtazapin beschrieben worden [26,27]. Das Switch-Risiko ist jedoch stark von der angewendeten Dosierung und der Begleitmedikation abhängig [28,29].…”

Section: ▼ Anamneseunclassified

Akute Psychose nach Konsum von synthetischen Cannabinoiden

Mörkl¹,

Blesl²,

Wurm

et al. 2016

Fortschr Neurol Psychiatr

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Section: ▼ Anamneseunclassified

Akute Psychose nach Konsum von synthetischen Cannabinoiden

Mörkl¹,

Blesl²,

Wurm

et al. 2016

Fortschr Neurol Psychiatr

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show abstract

“…3 of those patients were treated in monotherapy with the antidepressant dose ( ≥ 30 mg/day) of mirtazapine [24][25][26]. One of those patients may have been at higher risk of switching, because she was an older patient and the treatment with mirtazapine was started without a period of washout from fluoxetine (20 mg/ day) [26].…”

Section: Mirtazapinementioning

confidence: 99%

Low Risk for Switch to Mania during Treatment with Sleep Promoting Antidepressants

et al. 2015

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Introduction: Sleep-promoting antidepressants are of interest because they are used not only as antidepressants, but also to promote sleep. Methods: We reviewed case reports describing the switch to mania during treatment with trazodone, mirtazapine, or agomelatine. Results: Trazodone, mirtazapine, and agomelatine may induce manic symptoms. However, the risk of switching is related, first of all, to doses recommended for antidepressant treatment, administered without mood-stabilizer co-therapy. Low doses of these antidepressants, used for their hypnotic or sedative effects, were observed to cause mania only in patients with other risk factors for switching. There is no evidence for trazodone or mirtazapine and only sparse evidence for agomelatine, claiming that treatment with these antidepressants is related to an increased risk of switching to mania when administered in combination with a mood stabilizer. Discussion: These findings suggest that low doses of trazodone and mirtazapine are safe in bipolar disorder, and should still be considered important alternatives to hypnotics when long-term pharmacological treatment of insomnia is necessary. It seems that these antidepressants and agomelatine can also be used safely in antidepressant doses when combined with a mood stabilizer.

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“…His inpatient psychiatrists discontinued mirtazapine, raised valproic acid to 500 mg twice daily, added zolpidem at 10 mg at night for sleep, and started clonazepam at 1 mg twice daily for anxiety. I informed him that mirtazapine can flip patients into mania (45,46) and that his valproic level was not therapeutic. He did not like clonazepam since it made him feel restless.…”

Section: Clinical Historymentioning

confidence: 99%

The Psychiatric Cultural Formulation

Aggarwal

2012

Journal of Psychiatric Practice

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This paper considers revisions to the DSM-IV Outline for Cultural Formulation from the perspective of clinical practice. First, the paper explores the theoretical development of the Cultural Formulation. Next, a case presentation demonstrates challenges in its actual implementation. Finally, the paper recommends a set of questions for the clinician on barriers to care and countertransference. The development of a standardized, user-friendly format can increase the Cultural Formulation’s utilization among all psychiatrists beyond those specializing in cultural psychiatry.

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Mania Associated with Mirtazepine Treatment and Mixed Depression

Cited by 6 publications

References 10 publications

Akute Psychose nach Konsum von synthetischen Cannabinoiden

Akute Psychose nach Konsum von synthetischen Cannabinoiden

Low Risk for Switch to Mania during Treatment with Sleep Promoting Antidepressants

The Psychiatric Cultural Formulation

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