A Case of Fluoxetine Induced Mania

Bahk, Won Myong; Pae, Chi Un; Chae, Jeong Ho; Jun, Tae youn; Kim, Kwang Soo

Abstract

Serotonin selective reuptake inhibitors have been demonstrated to be effective in the treatment of patients who are vulnerable to antidepressant-induced side effects. However, fluoxetine known as generally safe and well tolerated drug, has been recently reported to induce mania. Also we have observed a case of fluoxetine-induced mania and report it here. Mr. A, 56 year-old male patient who has fluoxetine-treatment history with range of 10-40 mg/day due to depressive episode for 2 months, visited our outpatient department because of recurrent depressive episode. Upon that time Mr. A had not received any psychotropics and so he was free from any antidepressive agent for about 1 year. He has been suffering from moderate to severe recurrent depressive episode with depressed mood, loss of appetite, insomnia, and loss of volition upon visiting us. Fluoxetine 20 mg/day at morning was prescribed for control of his depressive symptoms without combined psychotropics. 31 days later he became overtly manic, with sleep deterioration, pressured speech, increased energy, elevated mood, and hyperactivity and so was admitted to hospital by his family. The fluoxetine was discontinued immediately and, mood stabilizer and antipsychotic were given to him. His manic symptom was started to remit in 10 hospital days and Mr. A left hospital with euthymic state on 42th hospital day.