Antidepressant-Withdrawal Mania: A Critical Review and Synthesis of the Literature
Abstract
BACKGROUND: Hypomania or mania have rarely been reported to develop shortly after the discontinuation of an antidepressant drug. The true incidence of this discontinuation syndrome is unknown because it may be underreported as a consequence of underrecognition or misattribution. This article examines the possible etiology, nosology, mechanisms, and other aspects of the syndrome. DATA SOURCES AND STUDY SELECTION: A PubMed search was conducted in May 2003 and repeated in January 2004 using the search terms antidepressant and mania. Relevant articles containing adequate descriptions for presentation were retrieved, and their reference lists were hand-searched for further pertinent material. Hand-searches of the indexes of leading psychiatry journals were also performed for the years 1998-2003. Twenty-three articles were identified for review. CONCLUSIONS: Antidepressant-withdrawal hypomania or mania may occur rarely with almost any antidepressant drug after sudden withdrawal, tapered discontinuation, or even merely a decrease in dose. The syndrome may be self-limiting, may abate with the reinstitution of the antidepressant drug, or may require specific anti-manic treatments; mood stabilizers do not necessarily protect against the syndrome. The true incidence of the syndrome is unknown. Narrow and broad diagnostic criteria are proposed for the syndrome, and a synthesis of literature is provided.
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Few studies reported rebound anxiety after venlafaxine discontinuation.
“Few studies also reported on rebound anxiety after venlafaxine discontinuation [115, 116].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [115]
Discontinuation of antidepressant medications may also trigger hypomania or mania, despite concurrent mood-stabilizing treatment.
“Discontinuation of antidepressant medications may also trigger hypomania or mania, despite concurrent mood-stabilizing treatment.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [47]
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- Authors
- Andrade, C.
- Affiliations
- National Institute of Mental Health and Neurosciences (IN)
- Corresponding author
- Andrade, Chittaranjan
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2004-07-15
- Volume
- 65
- Issue
- 7
- Pages
- 987-993
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2014414923
- Cited by
- 49
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2015: 3 · 2014: 2 · 2013: 4 · 2012: 1
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- antidepressant discontinuation, mania, hypomania, antidepressant discontinuation syndrome, antidepressant tapering, dose reduction, etiology, disease classification, diagnostic criteria, mood stabilizers, self-limiting course
- MeSH terms
- Antidepressive Agents, Bipolar Disorder, Depressive Disorder, Diagnosis, Differential, Humans, Substance Withdrawal Syndrome, Syndrome, Incidence, Antimanic Agents, PubMed
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