Mirtazapine is a pharmacological agent frequently used both as an antidepressant and as a hypnotic sedative agent. However, manic shift, an important side effect of other antidepressants, has not been adequately addressed in the treatment of mirtazapine, and the evidence has been only available from case reports. This mini-review and case report aimed to compile case reports on mirtazapine related manic shifts and to report a case where a manic shift was determined relatively early compared to that in these cases.
Mirtazapin hem antidepresan olarak hem de hipnotik sedatif etkisi nedeni ile sıkça kullanılan bir farmakolojik ajandır. Ancak diğer antidepresanlarda önemli bir yan etki olan manik kayma, mirtazapin tedavisinde yeterince ele alınmamış, kanıtlar genellikle olgu sunumu aşamasında kalmıştır. Bu mini-derleme ve olgu sunumunda mirtazapinle ilişkili manik kayma ile ilgili olgu sunumlarını derleyerek, bu olgulara göre çok daha kısa sürede manik kaymanın izlendiği bir vakanın sunulması planlanmıştır.
REFERENCES
1.de Boer T. The effects of mirtazapine on central noradrenergic and serotonergic neurotransmission. Int Clin Psychopharmacol 1995; 10(Spull.4):19-23.
2.Wichniak A, Wierzbicka A, Jernajczyk W. Sleep and antidepressant treatment. Curr Pharm Des 2012; 18:5802-5817.
3.Allain N, Leven C, Falissard B, Allain JS, Batail JM, Polard E, Montastruc F, Drapier D, Naudet F. Manic switches induced by antidepressants: an umbrella review comparing randomized controlled trials and observational studies. Acta Psychiatr Scand 2017; 135:106-116.
4.Koszewska I, Rybakowski JK. Antidepressant-induced mood conversions in bipolar disorder: a retrospective study of tricyclic versus non-tricyclic antidepressant drugs. Neuropsychobiology 2009; 59:12-16.
5.Post RM, Altshuler LL, Leverich GS, Frye MA, Nolen WA, Kupka RW, Suppes T, McElroy S, Keck PE, Denicoff KD, Grunze H, Walden J, Kitchen CM, Mintz J. Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline. Br J Psychiatry 2006; 189:124-131.
6.Pacchiarotti I, Bond DJ, Baldessarini RJ, Nolen WA, Grunze H, Licht RW, Post RM, Berk M, Goodwin GM, Sachs GS, Tondo L, Findling RL, Youngstrom EA, Tohen M, Undurraga J, González-Pinto A, Goldberg JF, Yildiz A, Altshuler LL, Calabrese JR, Mitchell PB, Thase ME, Koukopoulos A, Colom F, Frye MA, Malhi GS, Fountoulakis KN, Vázquez G, Perlis RH, Ketter TA, Cassidy F, Akiskal H, Azorin JM, Valentí M, Mazzei DH, Lafer B, Kato T, Mazzarini L, Martínez-Aran A, Parker G, Souery D, Ozerdem A, McElroy SL, Girardi P, Bauer M, Yatham LN, Zarate CA, Nierenberg AA, Birmaher B, Kanba S, El-Mallakh RS, Serretti A, Rihmer Z, Young AH, Kotzalidis GD, MacQueen GM, Bowden CL, Ghaemi SN, Lopez-Jaramillo C, Rybakowski J, Ha K, Perugi G, Kasper S, Amsterdam JD, Hirschfeld RM, Kapczinski F, Vieta E. The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. Am J Psychiatry 2013; 170:1249-1262.
7.Benazzi F. Antidepressant-associated hypomania in outpatient depression: a 203-case study in private practice. J Affect Disord 1997; 46:73-77.
8.Boerlin HL, Gitlin MJ, Zoellner LA, Hammen CL. Bipolar depression and antidepressant-induced mania: a naturalistic study. J Clin Psychiatry 1998; 59:374-379.
9.De León OA, Furmaga KM, Kaltsounis J. Mirtazapine-induced mania in a case of poststroke depression. J Neuropsychiatry Clin Neurosci 1999; 11:115-116.
10.Wichniak A, Jarkiewicz M, Okruszek Ł, Wierzbicka A, Holka-Pokorska J, Rybakowski J. Low risk for switch to mania during treatment with sleep promoting antidepressants. Pharmacopsychiatry 2015; 48:83-88.
11.Basavraj V, Nanjundappa GB, Chandra PS. Mirtazapine induced mania in a woman with major depression in the absence of features of bipolarity. Aust N Z J Psychiatry 2011; 45:901-902.
12.Liu CC, Liang KY, Liao S-C. Antidepressant-associated mania: soon after switch from fluoxetine to mirtazapine in an elderly woman with mixed depressive features. J Psychopharmacol 2009; 23:220-222.
13.Habermeyer B, Bayer U, Müller-Spahn F. Mania associated with mirtazapine treatment and mixed depression. Pharmacopsychiatry 2010; 43:37-38.
14.Bhanji NH, Margolese HC, Saint-Laurent M, Chouinard G. Dysphoric mania induced by high-dose mirtazapine: a case for ‘norepinephrine syndrome’? Int Clin Psychopharmacol 2002; 17:319-322.
15.Prost E, Abraham G. Mirtazapine-induced shopping spree. Can J Psychiatry 2004; 49:495.
16.Ng B. Mania associated with mirtazapine augmentation of fluoxetine. Depress Anxiety 2002; 15:46-47.
17.Soutullo CA, McElroy SL, Keck PE Jr. Hypomania associated with mirtazapine augmentation of sertraline. J Clin Psychiatry 1998; 59:320.
18.Goyal N, Sinha VK. Mirtazapine-induced manic switch in adolescent unipolar depression. Aust N Z J Psychiatry 2008; 42:1070-1071.
19.MacCall C, Callender J. Mirtazapine withdrawal causing hypomania. Br J Psychiatry 1999; 175:390.
20.Verma JK, Mohapatra S. Mirtazapine withdrawal-induced mania. J Pharmacol Pharmacother 2015; 6:214-215.
21.Viktorin A, Lichtenstein P, Thase ME, Larsson H, Lundholm C, Magnusson PKE, Landén M. The risk of switch to mania in patients with bipolar disorder during treatment with an antidepressant alone and in combination with a mood stabilizer. Focus (Am Psychiatr Publ) 2015; 13:68-74.
22.Montgomery SA. SAT-7-5 Safety of mirtazapine: a review. Eur Neuropsychopharmacol 1995; 5:263-264.
23.Gao K, Kemp DE, Ganocy SJ, Muzina DJ, Xia G, Findling RL, Calabrese JR. Treatment-emergent mania/hypomania during antidepressant monotherapy in patients with rapid cycling bipolar disorder. Bipolar Disord 2008; 10:907-915.