"Escitalopram induced mania has been reported in an adult with unipolar depressive disorder (Prapotnik et al. 2004). Also Pravin et al. (2004) described an adolescent with severe major depression and a family history of depression who developed mania with concomitant use of citalopram and escitalopram. But a recent study that examined the efficiency and safety of escitalopram (10–20 mg/day) in children and adolescents with depression revealed one patient with manic reaction treated with placebo but none with escitalopram (Wagner et al. 2006). "
[Show abstract][Hide abstract] ABSTRACT: There has been much recent attention on the adverse effects of serotonin reuptake inhibitors on children and adolescents. One well-known adverse effect of antidepressants in adults is manic induction. Our group recently used an administrative database to study the effects of age on antidepressant-induced manic conversion and found that peri-pubertal children may be most vulnerable to manic induction. This review will address the following questions: (1) What is known about antidepressant-induced mania and rapid cycling in children and adolescents? (2) Could antidepressant exposure in children and adolescents lead to long-term mood destabilization?; and finally, (3) What research and clinical recommendations can be made based on what is known thus far?
International Review of Neurobiology 02/2005; 65:25-52. DOI:10.1016/S0074-7742(04)65002-1 · 2.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Several factors have amplified concern about the possibility that antidepressant medication may contribute to induction of pediatric mania. These include the high rate of antidepressant medication prescription, the recent surge in the rate of diagnosis of pediatric bipolar disorder in the USA, and a growing number of case reports and clinical studies showing coincidence of manic symptoms with antidepressant pharmacotherapy in both youths and adults. However, the question of how medications and manic symptoms might be related is complicated, and decisive research studies with rigorous designs for evaluating the issues have not been published. The situation makes it difficult for practitioners to make good, evidence-based decisions. The scientific literature is ambiguous, and the stakes are high. We review the extant literature, offer seven different conceptual models of how medication and mania might be related, and comment on the evidence and clinical implications of each.
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