Drug-induced mania--causative agents, clinical characteristics and management. A retrospective analysis of the literature.

128 case reports of drug-induced mania were reviewed. Steroids, levodopa and other dopaminergic agents, iproniazid, sympathomimetic amines, triazolobenzodiazepines and hallucinogens were the agents that most commonly induced manic syndromes. The most common characteristics of drug-induced manic episodes were increased activity, rapid speech, elevated mood, and insomnia. Patients who developed mania often had a prior history, family history, or current symptoms of mood disturbance. The episodes were most commonly treated by discontinuing or reducing the dose of causative agent. Discontinuation of the inciting drug and treatment with neuroleptic agents were equally efficacious: lithium treatment was less effective. The majority of agents that induce mania have an effect on monoaminergic systems.