抗抑郁药相关躁狂是否总是双相谱系障碍的证据？病例报告及文献复习。
Is antidepressant-associated mania always an evidence of a bipolar spectrum disorder? A case report and review of the literature.
机构信息
Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356073, Seattle, WA 98195-6073, USA.
出版信息
Gen Hosp Psychiatry. 2013 Sep-Oct;35(5):577.e1-2. doi: 10.1016/j.genhosppsych.2012.12.012. Epub 2013 Jan 28.
OBJECTIVE
The authors consider the clinical implications of characterizing every case of antidepressant-induced mania as evidence of an underlying bipolar diathesis.
METHOD
The authors report the case of a 45-year-old man, with no personal or family history of bipolar symptoms, who developed manic symptoms after sertraline initiation for a first lifetime depressive episode.
RESULTS
The patient's manic symptoms resolved rapidly with cessation of sertraline. His depressive symptoms responded to mirtazapine, and he had no further mood episodes during 2-year follow-up.
DISCUSSION
It may not always be appropriate to identify selective serotonin reuptake inhibitor-induced manic symptoms as pathognomonic for the bipolar diathesis, particularly as the bipolar formulation has distinct implications for future pharmacologic choices.
目的
作者认为将每一例抗抑郁药诱发躁狂的病例都描述为潜在双相障碍素质的证据具有临床意义。
方法
作者报告了一例 45 岁男性的病例，他在首次出现单相抑郁发作时开始服用舍曲林，之后出现了躁狂症状，既无个人或家族双相症状史。
结果
该患者的躁狂症状迅速停止服用舍曲林后缓解。他的抑郁症状对米氮平有反应，在 2 年随访期间没有出现其他情绪发作。
讨论
将选择性 5-羟色胺再摄取抑制剂诱发的躁狂症状确定为双相障碍素质的特征可能并不总是合适的，特别是因为双相障碍的表述对未来的药物选择有明显的影响。
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