Surineni Kamalakar, Armstrong Austin, Wallace Sara, Schrader Nolan
Psychiatry and Behavioral Sciences, University of Kansas School of Medicine Wichita, Wichita, USA.
Cureus. 2024 Jun 29;16(6):e63441. doi: 10.7759/cureus.63441. eCollection 2024 Jun.
The abrupt transition into mania, known as a bipolar switch, poses a significant challenge in the treatment of mental illnesses. We present a case of a 22-year-old Hispanic female with generalized anxiety disorder (GAD) and autism spectrum disorder (ASD) who developed mania within five days after initiating escitalopram 5 mg. The patient had no reported history of bipolar disorder prior to this episode, and an extensive medical workup ruled out organic causes. The patient was in the acute inpatient psychiatric unit for 25 days and returned to baseline after discontinuation of escitalopram and initiating divalproex and olanzapine. This case underscores the potential risk of a bipolar switch with antidepressant use and highlights the importance of vigilant monitoring and considering underlying bipolarity in such patients.
突然转变为躁狂，即所谓的双相转换，在精神疾病治疗中构成重大挑战。我们报告一例22岁西班牙裔女性病例，该患者患有广泛性焦虑症（GAD）和自闭症谱系障碍（ASD），在开始服用5毫克艾司西酞普兰后五天内出现躁狂。在此发作之前，该患者无双相情感障碍病史报告，广泛的医学检查排除了器质性病因。患者在急性住院精神科病房住院25天，停用艾司西酞普兰并开始使用丙戊酸和奥氮平后恢复至基线状态。该病例强调了使用抗抑郁药导致双相转换的潜在风险，并突出了对此类患者进行密切监测和考虑潜在双相性的重要性。
