Dealberto Marie-José, Marino Josie, Bourgon Luc
Department of Psychiatry, Ottawa Hospital, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Bipolar Disord. 2008 Feb;10(1):111-3. doi: 10.1111/j.1399-5618.2008.00523.x.
Mood disorders are more frequent after brain injury and both depressive and manic episodes are associated in these patients with an increased risk of aggression. Antidepressant medications are associated with a risk of manic induction.
We describe a case of homicidal ideation with intent during the onset of a manic episode in a patient with prior brain injury on antidepressant medication at low dosage. The manic episode could have been secondary to brain injury and/or triggered by antidepressant medications. This case raises the possibility of the sensitizing role of brain injury for antidepressant-induced mania.
Further studies are needed to assess the role of brain injury as a risk factor for antidepressant-induced mania. Physicians should be cautious when prescribing antidepressants to patients with prior brain injury and inform them and their relatives of the possibility of a switch into mania.
